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ambulatory clinical populationにおける早期再偏極化について
Abhimanyu Uberoi1, Nikhil A Jain, Marco Perez
1Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, CA, USA. manu.uberoi@gmail.com
Circulation
|October 12, 2011
まとめ
STセグメントの上昇とJ波を含むECGの早期再極化パターンは,この大規模な研究で心臓死亡率と有意に関連していない. 臨床的意義を理解するためにさらなる研究が必要である.
科学分野:
- 心臓病学 心臓病学
- エレクトロカーディオグラフィーです.
- 公衆衛生は公衆衛生である.
背景:
- 早期再極化 (ER) パターンの臨床的意義は,特にR波のダウンスロープ形態学に関する心電図 (ECG) において議論されている.
- 以前の研究では,ERコンポーネントの予後値に関して矛盾する結果が得られた.
研究 の 目的:
- 様々な早期再偏極化パターンと心血管疾患による死亡率の関連性を調査する.
- 大規模で多様な集団におけるSTセグメントの上昇,J波,QRSスラージングの予後的な影響を明確にするために.
主な方法:
- VAパロアルト保健医療システムからの休憩中の29281の歩行心電図の分析.
- 標準的な基準に基づいてSTセグメントの高さ,J波,およびスラースの定義,PR間隔をイソ電気線とする.
- コックス比例危険性分析は,心血管疾患による死亡率との関連を平均7.6年の追跡期間で評価した.
主要な成果:
- 被験者の2.3%が下部または横部STセグメントの上昇を示し,14%がJ波またはスラージングを示した.
- J波/スラージングは,STセグメントの上昇 (61%対13%) を有する被験者においてより一般的であった.
- すべてのERパターンは,年齢調整前に心血管疾患による死亡率の減少と関連していたが,年齢調整後にこの関連性は重要性が失われました.
結論:
- 早期再偏極化成分 (STセグメントの上昇,J波,スラース) と,年齢を調整した後の心臓死亡率との間に有意な関連性が見つかりませんでした.
- 心血管疾患の結果を予測する早期再偏極化の予後的価値は,特に人口統計的要因を考慮すると,依然として不確実です.
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