电心电图作为查工具,以排除慢性静心性心力衰竭与左心室排气分数减少的情况
Roda Abdulkadir Mohamed1,2, Søren Auscher1,2, Thomas Rueskov Andersen1,2
1Department of Clinical Research, University of Southern Denmark.
在初级保健中,心电图 (ECG) 可以有效地选心力衰竭 (HF) 与左心室排气分数 (LVEF) 的降低. 正常的心电图可靠地排除HF,帮助医生识别需要进一步评估的患者.
科学领域:
- 心脏病学 心脏病学
- 医学诊断 医学诊断 医学诊断
- 主要护理医学 医疗保健
背景情况:
- 对心声回声学等待时间的增加影响了新发性心力衰竭 (HF) 的及时诊断.
- 需要查工具来识别患有HF的患者,特别是那些左心室射出分数 (LVEF) 减少的患者.
- 电心电图 (ECG) 是一种潜在的非侵入性查方法.
研究的目的:
- 评估心电图在初级保健转诊中识别低 LVEF 的高脉的诊断价值.
- 为了比较自动心电图解释和心脏病学家解释的诊断准确性.
- 评估ECG作为HF诊断的守门工具的实用性.
主要方法:
- 追溯观察性研究 (2020-2021年) 涉及248名因怀疑高血压而从初级保健中转诊的患者.
- 所有患者都在进行心电图之前进行心声回声扫描,以评估LVEF.
- 分析包括诊断值,负预测值,以及对风险预测模型的影响.
主要成果:
- 61.5%的患者有异常的心电图;7.7%的患者有LVEF≤40%.
- 异常心电图显著与减少的LVEF相关.
- 电脑心电图的负预测值为99%,不管使用的是哪种解释方法 (心脏病专家与自动).
- 电心电图改善了物流风险模型在曲线下的面积,从0.72提高到0.79.
结论:
- 正常的心电图可以安全地排除LVEF<50%的HF.
- 电脑心电图 (ECG) 作为初级保健医生管理疑似新发性缩性HF的有效守门工具.
- 这项研究是第一个比较HF查的自动和心脏病学家ECG解释.
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