心电图特征在预测心肌梗死后左心室壁瘤相关快速室性心律失常的价值

Values of Electrocardiogram in Predicting Left Ventricular Aneurys-Related Rapid Ventricular Arrhythmia After Myocardial Infarction

目的探讨心电图特征在预测心肌梗死后左心室室壁瘤相关快速室性心律失常的价值。方法选取2011年1月至2021年1月在四川大学华西广安医院就诊的心肌梗死后左心室室壁瘤82例患者的临床资料进行分析。根据是否合并快速室性心律失常分为观察组(n=25)和对照组(n=57)。分析两组临床资料、心电图参数差异。结果两组性别、年龄、体质指数等一般资料比较差异无统计学意义(P>0.05)。观察组窦性心律RR间期标准差(SDNN)、QRS-T夹角>90°比例、QTC间期、T波峰-末间期(Tp-Te)、碎裂QRS波(fQRS)比例和J波比例明显高于对照组,差异有统计学意义(P<0.05)。SDNN、QRS-T夹角>90°、QTC间期、Tp-Te、fQRS和J波预测快速室性心律失常的ROC曲线下面积分别为0.786、0.855、0.755、0.659、0.627和0.709(P<0.05)。其中SDNN、QRS-T夹角和J波联合预测的ROC曲线下面积0.942,灵敏度和特异度分别为87.00%和92.50%。观察组治疗后SDNN、QRS-T夹角>90°比例、QTC间期、Tp-Te、fQRS比例和J波比例明显低于治疗前,差异有统计学意义(P<0.05)。结论心电图参数:SDNN、QRS-T夹角及J波在预测心肌梗死后左心室壁瘤相关快速室性心律失常中有较高价值。

Objective To explore values of ECG characteristics in predicting left ventricular aneurysm-related rapid ventricular arrhythmia after myocardial infarction.Methods From January 2011 to January 2021, clinical data of patients with left ventricular aneurysm after myocardial infarction in our hospital were selected for analysis, and 82 cases were analyzed. According to whether they were combined with tachyarrhythmia, they were divided into observation group(OG,n=25)and control group(CG,n=57). Differences in clinical data and ECG parameters were analyzed. Results There was no significant difference between OG and CG in gender, age, body mass index and other general clinical data(P>0.05). In OG, sinus rhythm RR interval standard deviation(SDNN), QRS-T included angle>90° ratio, QTC interval, T wave peak-terminal interval(Tp-Te), fragmented QRS complex(fQRS)ratio and J wave ratio was significantly higher than that of the CG(P<0.05). SDNN, QRS-T included angle>90°, QTC interval, Tp-Te, fQRS and J wave prediction of rapid ventricular arrhythmia, area under the ROC curve were 0.786, 0.855, 0.755, 0.659, 0.627 and 0.709(P<0.05). Area under the ROC curve predicted by SDNN, QRS-T angle and J wave was 0.942, and sensitivity and specificity were 87.00% and 92.50%, respectively. Ratio of SDNN, QRS-T included angle>90°, QTC interval, Tp-Te, fQRS ratio and J wave ratio after treatment in OG were significantly lower than before treatment(P<0.05). Conclusion ECG parameters, including SDNN, QRS-T included angle and J wave would have high value in predicting left ventricular aneurysm-related rapid ventricular arrhythmia after myocardial infarction.