AECGs-MTWA技术对慢性心力衰竭患者心源性猝死的预测价值分析  

Predictive value of AECGs-MTWA for sudden cardiac death in patients with chronic heart failure

作　　者：匡春元 袁维姝 石文海 马敏[1] KUANG Chun-yuan;YUAN Wei-shu;SHI Wen-hai(Departement of Cardiovascular Medicine,Chengdu Sixth People's Hospital,Chengdu Sichuan 610000,China)

机构地区：[1]成都市第六人民医院心血管内科,四川成都610000

出　　处：《临床和实验医学杂志》2023年第17期1829-1831,共3页Journal of Clinical and Experimental Medicine

基　　金：四川省中医药管理局课题(编号:2020LC0019)。

摘　　要：目的探究24 h动态心电图微伏级T波电交替(AECGs-MTWA)技术对慢性心力衰竭(CHF)患者心源性猝死(SCD)的预测价值。方法选取2019年4月至2021年7月期间成都市第六人民医院收治的96例CHF患者为研究对象,所有患者均行动态心电图(AECGs)检查,并借助时域分析法移动平均修正技术分析24 h AECGs-MTWA,测量V1导联及V5导联中的MTWAmax及8∶00amMTWA;随访1年,主要终点为SCD,次要终点为CHF死亡,根据患者结局将其分为存活组、SCD组、非SCD组,比较3组基线资料、V1导联及V5导联MTWA最大值及8∶00amMTWA,采用受试者工作特征(ROC)曲线分析对CHF患者SCD的预测效能。结果3组基线资料比较,差异均无统计学意义;3组V1导联及V5导联中的MTWAmax及8∶00amMTWA比较,差异均有统计学意义(P<0.05);SCD组V1导联及V5导联中的MTWAmax及8∶00amMTWA均低于存活组,差异均有统计学意义(P<0.05),但存活组、非SCD组上述指标比较,差异均无统计学意义(P>0.05)。ROC曲线结果分析,V1导联MTWAmax预测SCD的曲线下面积、敏感度、特异度分别为0.865、76.00%、88.50%;V5导联MTWAmax预测SCD的曲线下面积、敏感度、特异度分别为0.851、72.00%、92.30%;V1导联8∶00amMTWA预测SCD的曲线下面积、敏感度、特异度分别为0.846、80.00%、88.50%;V5导联8∶00amMTWA预测SCD的曲线下面积、敏感度、特异度分别为0.861、80.00%、90.04%。结论AECGs-MTWA技术对CHF患者发生SCD具有一定的预测价值,可为临床诊疗提供科学依据。Objective To explore the predictive value of 24 h ambulatory ECGs-microvolt T-wave alternating(AECGs-MTWA)for sudden cardiac death(SCD)in patients with chronic heart failure(CHF).Methods A total of 96 patients with CHF admitted to Chengdu Sixth People's Hospital from April 2019 to July 2021 were retrospectively selected as the study subjects.All patients underwent ambulatory ECGs(AECGs)examination.The 24 h AECGs-MTWA was analyzed by modified moving average of time domain analysis.MTWAmax and 8∶00amMTWA in V1 lead and V5 lead and 8∶00amMTWA were measured.The primary and secondary endpoints of the 1 year of follow-up were SCD and CHF death.Patients were divided into survival group,SCD group,non-SCD group according to the outcomes.The baseline data,maximum MTWA values of V1 lead and V5 lead were compared among the 3 groups.The predictive performance of AECGs-MTWA for SCD in CHF patients was analyzed using the receiver operating characteristic(ROC)curve.Results There were no statistically significant differences in baseline data between the 3 groups.There were significant differences in MTWAmax and 8∶00am MTWA in V1 lead and V5 lead among the three groups,the differences were statistically significant(P<0.05);the above indexes in the SCD group were lower than those in the survival group,the differences were statistically significant(P<0.05),but there were no statistically significant difference between the survival group and the non-SCD group(P>0.05).ROC curve analysis results showed that the area under the curve(AUC)values,sensitivity and specificity of V1-lead MTWAmax,V5-lead MTWAmax,V1-lead 8∶00amMTWA and V5-lead 8∶00amMTWA for predicting SCD were(0.865,76.00%,88.50%),(0.851,72.00%,92.30%),(0.846,80.00%,88.50%)and(0.861,80.00%,90.04%),respectively.Conclusion AECGs-MTWA has certain predictive value for SCD in patients with CHF,providing a scientific basis for clinical diagnosis and treatment.

关 键 词：心力衰竭 心源性猝死 动态心电图 微伏级T波电交替 预测 

分 类 号：R541.6[医药卫生—心血管疾病]