基于心电图的虚假阳性诊断左心室缩在心动减速期间:还需要做些什么?
1Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Cardiology Department, Elmhurst Hospital Center, Elmhurst, NY, United States of America.
过渡的错误阳性心电图 (ECG) 诊断的左心室缩 (LVH) 可以发生在心跳动期间,由于改变了LV尺寸. 这种洞察力可以防止误诊,并为心力衰竭评估提供信息.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 电心电图是指心电图.
背景情况:
- 对左心室缩 (LVH) 的心电图 (ECG) 解释可能是复杂的.
- 慢心跳,即心率快,可以影响心电图的结果.
- 之前的观察表明,高心率期间可能存在心电图异常.
研究的目的:
- 用于描述 LVH 的过渡性错误阳性心电图诊断在患有心动减速症的患者中.
- 为了阐明这种心电图现象背后的机制.
- 建议对自动ECG解释和心力衰竭诊断的影响.
主要方法:
- 对ECG和心脏成像的回顾性分析来自患有各种心跳动症的患者.
- 审查与心脏尺寸和心电图信号传输相关的既定生理原则.
- 电脑心电图发现与成像验证的LVH和心力衰竭状态的临床相关性.
主要成果:
- 在患有心跳动脉动症 (鼻腔,脑上脉,心房动) 的患者中观察到LVH过渡的错误阳性心电图诊断.
- 拟议的机制涉及心动节拍诱导缩短腹心左心室 (LV) 尺寸,将LV体积中心离胸壁更近 (威尔逊的近距离效应).
- 短心期间这种现象的缺失可能表明心力衰竭与腹缩扩张的晚期心力衰竭.
结论:
- 观察到的心电图现象可能导致不适当的LVH诊断,需要提高认识.
- 建议修改自动化的心电图解释算法来结合这一洞察力.
- 了解这种心电图人工物有助于准确评估LVH,并可能提供有关心力衰竭严重程度的线索.
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