Stellbrink C, Mischke K, Stegemann E, Killmann R, Minkenberg R, Lü X Y, Schütt H, Hanrath P
Department of Cardiology, University of Technology, Aachen, Germany.
Int J Cardiol. 1999 Jul 31;70(2):109-18. doi: 10.1016/s0167-5273(99)00058-3.
Body surface potential maps (BSPM) from patients with coronary artery disease or no structural heart disease were analyzed with respect to their spatial features and QT/QTc dispersion in order to determine whether BSPM allows identification of patients with ventricular fibrillation. QRST integral maps and QT/QTc dispersion were acquired from simultaneous recordings of 62 ECG leads during sinus rhythm in patients with idiopathic ventricular fibrillation (n=13), ventricular fibrillation and coronary artery disease (n=22), coronary artery disease without ventricular fibrillation (n=21) and healthy controls (n=18). The Karhunen-Loeve transformation was applied to reduce the dimensionality of the data matrix of the QRST map to eight coefficients. Linear discriminant analysis allowed discrimination between idiopathic ventricular fibrillation patients and controls with high sensitivity (85%) and specificity (89%). However, discrimination between coronary artery disease patients with or without ventricular fibrillation was poor (68% and 67%, respectively). QTc dispersion calculated from BSPM was longer in idiopathic ventricular fibrillation patients than in controls (99+/-30 ms vs 70+/-14 ms, P=0.009) in contrast to QTc dispersion taken from 12-lead ECG (53+/-21 ms vs. 47+/-12 ms, P=n.s.). No significant difference was noted for coronary artery disease patients with or without ventricular fibrillation. In conclusion, repolarization disturbances detected by BSPM allow identification of ventricular fibrillation patients without structural heart disease. However, our results do not suggest a major impact of QT/QTc dispersion or QRST integral mapping for identification of ventricular fibrillation patients with coronary artery disease.
为了确定体表电位图（BSPM）是否能够识别出室颤患者，对患有冠状动脉疾病或无结构性心脏病患者的体表电位图的空间特征和QT/QTc离散度进行了分析。从特发性室颤患者（n = 13）、室颤合并冠状动脉疾病患者（n = 22）、无室颤的冠状动脉疾病患者（n = 21）和健康对照者（n = 18）的窦性心律期间同步记录的62导联心电图中获取QRST积分图和QT/QTc离散度。应用卡尔胡宁-洛伊夫变换将QRST图的数据矩阵维数降至八个系数。线性判别分析能够以高灵敏度（85%）和特异性（89%）区分特发性室颤患者和对照者。然而，区分有或无室颤的冠状动脉疾病患者的效果较差（分别为68%和67%）。与从12导联心电图得出的QTc离散度相比，特发性室颤患者通过BSPM计算出的QTc离散度更长（99±30毫秒对70±14毫秒，P = 0.009）（12导联心电图得出的QTc离散度为53±21毫秒对47±12毫秒，P无统计学意义）。有或无室颤的冠状动脉疾病患者之间未观察到显著差异。总之，BSPM检测到复极异常能够识别无结构性心脏病的室颤患者。然而，我们的结果并不表明QT/QTc离散度或QRST积分图对识别冠状动脉疾病室颤患者有重大影响。
