Abstract:Objective To judge whether the diagnostic value of ST-T changes for coronary heart disease(CHD) is higher than other indices. Methods A total of 385 patients were enrolled in our study, who had been admitted in the department of Cardiology in our hospital and underwent coronary arteringraphy(CAG). The ST-T changes of their ECGs were recorded statistically by Minnesota code, and the relationship between CAG results and ECG changes was analyzed. In addition, the patients with positive CAG results were classified according to the severity of CHD, and the relationship between ST-T changes of ECG and the severity of CHD was evaluated. Results In all the 385 cases who had undergone CAG examination, there were 297 cases with positive results in whom 177 were observed positive ECG changes; there were 88 cases with negative results in whom 30 were observed positive ECG changes, and the difference was statistically significant(P<0.000 1). Among the patients with positive CAG results, 97 cases were diagnosed with single vessel disease including 48 case with positive ECG results and 49 with negative ECG results; Two hundred cases were diagnosed with multivessel coronary artery disease including 129 case with positive ECG results and 71 with negative ECG results, and the difference was statistically significant(P<0.05). Conclusion If we analyze ECG with the standard of ST-T changes by Minnesota code, ST-T changes will be found clinically valuable in diagnosing CHD. Among the patients who were diagnosed with CHD, ST-T changes prove to have diagnostic value for the ones with multi-coronary artery disease.
苏冠丽, 韩彩莉, 籍文强, 刘刚. 心电图ST-T改变对冠心病的诊断价值[J]. 实用心电学杂志, 2016, 25(4): 233-239.
SU Guan-Li, HAN Cai-Li, JI Wen-Qiang, LIU Gang. Diagnostic value of ECG ST-T changes for coronary heart disease. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2016, 25(4): 233-239.
[1] Castro Heria J,Antzelevitch C,Tornés Bárzaga F,et al. TpeakTend and TpeakTend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada Syndrome [J].J Am Coll Cardiol,2006,47(9):1828-1834.[2] Okin PM,Malik M,Hnatkova K,et al.Repolarization abnormality for prediction of allcause and cardiovascular mortality in American Indians:the strong heart study[J].Cardiovasc Electrophysiol,2005,16(9):945-951.[3] Jensen JK,Bak S,Flemming HilundCarlsen P,et al. Prevalence of electrocardiographic ST-T changes during acute ischemic stroke in patients without known ischemic heart disease[J]. Int J Cardiol,2008,128(1):137-138.[4] Alan T. Marty.The minnesota code manual of electrocardiographic findings[J]. Critical care med,1983,11(7):583[5] Sokolow M,Lyon TP.The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads[J]. Am Heart J,1949,37(2): 161-186.[6] Yuko C,Hiroshi W,Masaomi C,et al. ST-T abnormalities on ECG in relation to cardiovascular risk factors [J]. J Arrhythmia,2011,27(3):202-207.[7] Badheka AO,Rathod A,Marzouka GR,et al.Isolated nonspecific ST-segment and T-wave abnormalities in a crosssectional United States population and mortality (from NHANES III)[J]. Am J Cardiol,2012,110(4):521-525.[8] 罗丽萍.常规静息心电图ST-T改变在老年冠心病诊断中的临床效果研究[J].中国保健营养,2012(11):4285.[9] Cohn PF,Fox KM,Daly C.Silent myocardial ischemia[J].Circulation,2003,108(10):1263-1277.[10] Jinzhong Song,Hong Yan,Zhijun Xiao,et al.A robust and efficient algorithm for STT complex detection in electrocardiograms[J].J Mech Med Biol,2011,11(5):1103-1111.[11] 郭继鸿.慢性冠状动脉供血不足心电图概念的质疑[J].心电学杂志,2003,22(1):21-27.[12] 张蓉.常规静息心电图ST-T改变在老年冠心病诊断中的临床价值[J].中国医药指南,2014,12(9):99-100.[13] Savonitto S,Ardissino D,Granger CB,et al.Prognostic value of the admission electrocardiogram in acute coronary syndromes[J].JAMA,1999,281(8):707-713.[14] Lin KB,Shofer FS,McCusker C,et al.Predictive value of Twave abnormalities at the time of emergency department presentation in patients with potential acute coronary syndromes[J].Acad Emerg Med,2008,15(6):537-543.[15] Tan NS,Goodman SG,Yan RT,et al.Comparative prognostic value of Twave inversion and STsegment depression on the admission electrocardiogram in nonSTsegment elevation acute coronary syndromes[J]. Am Heart J,2013,166(2):290-297.[16] Apurva OB,Nileshkumar JP,Peeyush MG,et al.STT wave abnormality in lead aVR and reclassification of cardiovascular risk (from the national health and nutrition examination surveyⅢ )[J]. Am J Cardiol,2013,112(6):805-810.[17] Rumana N,Turin TC,Miura K,et al. Prognostic value of ST-T abnormalities and left high R waves with cardiovascular mortality in Japanese (24year followup of NIPPON DATA80)[J]. Am J Cardiol,2011,107(12):1718-1724.[18] Dranca L,Goi A,Illarramendi A.Realtime detection of transient cardiac ischemic episodes from ECG signals [J].Physiol Meas,2009,30(9):983-998. [19] Taddei A,Distante G,Emdin M.The European ST-T database:standard for evaluating systems for the analysis of STT changes in ambulatory electrocardiography [J].Eur Heart J,1992,13(9):1164-1172.