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在门诊临床人群中早期的再极化
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
概括
在这项大型研究中,ECG上的早期再极化模式,包括ST段升高和J波,与心脏死亡率没有显著联系. 需要进一步的研究来了解它们的临床意义.
科学领域:
- 心脏病学 心脏病学
- 电心电图是指心电图.
- 公共卫生 公共卫生
背景情况:
- 关于心电图 (ECG) 上早期再极化 (ER) 模式的临床意义,特别是关于R波下坡形态的临床意义,仍在争论中.
- 之前的研究对ER组件的预后价值产生了相互矛盾的结果.
研究的目的:
- 调查各种早期再极化模式与心血管死亡率之间的关联.
- 为了澄清 ST 分段升高,J 波和 QRS 沉积在一个大而多样化的群体中的预后影响.
主要方法:
- 来自VA帕洛阿尔托医疗保健系统的29281个休息的门诊心电图的分析.
- 根据标准标准定义ST段的升高,J波和污垢,以PR间隔为同电线.
- 考克斯比例危险分析评估与心血管死亡率的关联,平均随访时间为7.6年.
主要成果:
- 2.3%的受试者表现出下部或侧部ST段的升高;14%的受试者表现出J波或形.
- 在ST段升高 (61%对13%) 的受试者中,J波/形更为普遍.
- 在年龄调整之前,所有ER模式都与心血管死亡率的降低有关,但在调整年龄后,这种关联失去了意义.
结论:
- 在对年龄进行调整后,在早期再极化组件 (ST段升高,J波,污垢) 和心脏死亡率之间没有发现显著的关联.
- 早期复极化的预后价值在预测心血管结果方面仍然不确定,特别是在考虑人口因素时.
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