基于ECG-ViEW数据库的心房颤动心电图预测特征研究  

Predictive characteristics of electrocardiogram for atrial fibrillation based on ECG-ViEW database

作　　者：张凤至 陈舒宁 徐宗政 王悦 李媛 王德国 Zhang Fengzhi;Chen Shuning;Xu Zongzheng;Wang Yue;Li Yuan;Wang Deguo(Department of Gerontology,First Affiliated Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]安徽省芜湖市皖南医学院第一附属医院(弋矶山医院)老年医学科,芜湖241000

出　　处：《中国循证心血管医学杂志》2025年第2期141-144,167,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：安徽省科技厅重点研究与开发项目(2022e07020019)。

摘　　要：目的运用公共ECG-ViEW数据库探讨体表心电图特征预测心房颤动(AF)发生的预测效果,为将来计算机辅助预测心房颤动技术提供基础。方法从公用信息平台ECG-ViEW心电图数据中筛选出心房颤动患者窦性节律时心电图,比较其与非心房颤动患者心电图参数差异。Logistics回归分析哪些心电图参数是心房颤动的风险因素。受试者操作曲线(ROC)分析以确定心电图参数判断心房颤动风险的特异性和敏感性。结果在181560例患者中,其中3431例为AF组(1.9%),178129例为非AF组(98.1%)。AF组心率快、PR间期、QRS波宽度、QTc间期显著高于非AF组(P<0.001)。而Hodges校正的QTc间期(95%CI:0.449~0.855,P=0.004)、异常P波电轴(左偏:95%CI:0.402~0.524,P<0.001;右偏:95%CI:0.630~0.786,P<0.001)、QRS-T角增宽(95%CI:3.165~3.871,P<0.001)是心房颤动独立风险因素。ROC显示纳入年龄和性别因素后,异常P波电轴、QTc-Hodges延长及QRS-T角增宽联合推测心房颤动的敏感性为0.705,特异性为0.686(AUC=0.739,95%CI:0.731~0.748,P<0.001)。结论心电图参数中的异常P波电轴、QTc延长及QRS-T角增宽3种心电图特征是心房颤动独立风险因素,可用于人群中心房颤动风险筛查。Objective To discuss the effect of surface electrocardiograms(ECG)characteristics in predicting atrial fibrillation(AF)by applying public ECG-ViEW database,and provide a basis for developing computerassisted AF prediction.Methods ECG of sinus rhythm was screened in AF patients from ECG data in public ECGViEW database,and differences in ECG parameters were compared between AF patients and non-AF patients.The risk factors for AF in ECG parameters were analyzed by using Logistic regression analysis.The specificity and sensitivity of ECG parameters in predicting AF risk were determined by using receiver operating characteristic(ROC)curve analysis.Results Among 181560 patients,there were 3431(1.9%)with AF(AF group),and there were 178129 without AF(non-AF group,98.1%).The heart rate was faster,and PR interval,QRS wave duration and QTc interval were significantly higher in AF group than those in non-AF group.Hodges-corrected QTc interval(95%CI:0.449~0.855,P=0.004),abnormal P wave axis(left deviation:95%CI:0.402~0.524,P<0.001;right deviation:95%CI:0.630~0.786,P<0.001),and widened QRS-T angle(95%CI:3.165~3.871,P<0.001)were independent risk factors for AF.The results of ROC curve analysis showed that,after including age and gender and in combination of abnormal P wave axis,prolonged QTc-Hodges and widened QRS-T angle for predicting AF,sensitivity 0.705,and specificity was 0.686(AUC=0.739,95%CI:0.731~0.748,P<0.001).Conclusion The ECG characteristics including abnormal P wave axis,prolonged QTc-Hodges and widened QRS-T angle are independent risk factors for AF,which can be used for AF risk screen in population.

关 键 词：心房颤动 QT间期 心电图 QTC间期 

分 类 号：R541.75[医药卫生—心血管疾病]