电心波P波高峰时间预测INOCA患者的显著缺血:试点研究
Muhammet Salih Ateş1, Erdoğan Sökmen1
1Department of Cardiology, Kırşehir Ahi Evran Training and Research Hospital, Kırşehir, Turkey.
Journal of electrocardiology
|September 6, 2025
概括
在非阻塞性冠状动脉 (INOCA) 患者中,延长的P波峰值时间 (PWPT) 与心肌缺血有关. 这种心电学标记,特别是在DII中,可以帮助识别冠状动脉微血管功能障碍.
科学领域:
- 心脏病学
- 诊断心电图
- 心脏缺血性疾病
背景情况:
- 非阻塞性冠状动脉缺血 (INOCA) 带来了诊断挑战,通常与冠状动脉微血管功能障碍 (CMD) 相关.
- 在INOCA患者中预测缺血的非侵入性心电学标志物具有临床意义.
- P波峰值时间 (PWPT) 是反映心房导电的心电指数,可能与缺血病理学有关.
研究的目的:
- 研究INOCA患者的P波峰值时间 (PWPT) 和心肌缺血之间的关联.
- 在INOCA中评估PWPT作为识别显著缺血和冠状动脉微血管功能障碍 (CMD) 的非侵入性标志物.
主要方法:
- 在444名INOCA患者进行冠状动脉动图和SPECT心肌输液成像 (MPI) 的回顾性观察研究.
- 通过数字测量P波指数,包括DII和V1的PWPT.
- 用多变量逻辑回归和ROC分析来确定显著缺血的预测因素 (> 10%),并评估PWPT的辨别能力.
主要成果:
- 在DII和V1线索中,长期PWPT与10%以上的可逆心肌缺血相关.
- PWPT- DII表现出强大的分辨能力 (AUC 0.82),表现优于PWPT- V1 (AUC 0.76).
- 在多变量分析中,PWPT- DII,PWPT- V1,年龄,糖尿病和E/ e'比是显著缺血的独立预测因素.
结论:
- 在INOCA患者中,PWPT,特别是DII的升高与心肌缺血有关.
- 在INOCA中,PWPT可以作为一种有价值的非侵入性工具,用于风险分层和早期检测CMD.
- 将PWPT整合到心电图解释中可以提高冠状动脉图和缺血症状正常的患者的诊断能力.
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