微伏级T波电交替在低中危冠心病患者的应用
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常州市卫生计生委重大科技项目(ZD201605)


The application of microvolt T⁃wave alternans in patients with low and moderate risk coronary artery disease
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    摘要:

    目的:分析低危、中危冠心病患者的微伏级T波电交替(microvolt T-wave alternans,MTWA)值与最大微伏级T波电交替(max-MTWA)值并评估低、中危冠心病患者猝死风险的差异。方法:选取确诊的冠心病患者112例作为冠心病组,非冠心病患者66例作为对照组,冠心病组再根据运动平板试验Duke评分(Duke treadmill score,DTS)分为两个亚组,即低危组(5分≤DTS≤15分)和中危组(-10分≤DTS<5分)。所有研究对象进行运动平板试验的同时用移动平均修正法测得max-MTWA值及其对应的心率(heart rate,HR)和MTWA值,计算max-MTWA值及其对应HR的比值(max-MTWA/HR),并比较各组患者max-MTWA值、max-MTWA/HR比值和MTWA值的差异。结果:冠心病组的max-MTWA值、max-MTWA/HR比值和MTWA值较对照组高,差异有统计学意义(P均<0.05),且max-MTWA值及max-MTWA/HR比值中危组>低危组>对照组,差异均具有统计学意义(P均<0.05)。对照组与低危组MTWA值的差异无统计学意义(P>0.05)。中危组的MTWA值明显高于对照组和低危组(P均<0.05)。结论:冠心病严重者max-MTWA值及max-MTWA/HR比值升高。低危冠心病患者猝死风险较低,与对照人群无差异,而中危冠心病患者猝死风险较低危冠心病患者高。

    Abstract:

    Objective: To analysis the values of microvolt T-wave alternans(MTWA) and maximum T-wave alternans(max-MTWA)in patients with low or moderate risk coronary artery disease(CAD),and assess the risk of sudden cardiac death(SCD). Methods:One hundred and twelve CAD patients were enrolled for this study,and sixty-six non-CAD patients as the control group. Based on the Duke treadmill test scores(DTS),CAD patients were divided into 2 groups:the low-risk CAD group(with scores ranging from 5 to 15)and the moderate-risk CAD group(with scores ranging from-10 to 5). All participants performed treadmill exercise stress tests and MTWA,max-MTWA and the heart rates(HR) at max-MTWA were recorded by the time-domain modified moving average beat analysis(MMA)method,then the ratio of max-MTWA/HR was calculated. Results:There were significant differences in max-MTWA,max-MTWA/HR ratio and MTWA values between the control group and the CAD group(all P<0.05). Furthermore,subgroup analysis showed that the max-MTWA and max-MTWA/HR ratio in the moderate-risk CAD group were higher than those in the low-risk CAD group,and the parameters in the low-risk CAD group were higher than those in the control group(all P<0.05). There was no significant difference in MTWA between the low-risk CAD group and the control group(P>0.05). However,MTWA in the moderate-risk CAD group were significantly higher than those in the low-risk CAD group and the control group(all P<0.05). Conclusion:max-MTWA and max-MTWA/HR ratio were significantly increased in patients with severe CAD. The risk of SCD in low-risk CAD patients was the low as the control group,while moderate-risk CAD patients have a higher risk of SCD.

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卞燕飞,颜紫宁,葛少洁.微伏级T波电交替在低中危冠心病患者的应用[J].南京医科大学学报(自然科学版),2021,(10):1468-1473

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  • 收稿日期:2021-02-23
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  • 在线发布日期: 2021-11-05
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