Yamada T, Fukunami M, Ohmori M, Kumagai K, Sakai A, Kondo N, Minamino T, Hoki N
Division of Cardiology, Osaka Prefectural Hospital.
J Cardiol. 1992;22(1):91-7.
We assessed the usefulness of ventricular late potentials (VLP) for detecting ventricular tachycardia (VT), and of the relationship between VLP and left ventricular dysfunction. The subjects consisted of 21 patients with dilated cardiomyopathy (DCM) not accompanied with ventricular conduction disturbances. Signal-averaged electrocardiograms were recorded by using VCM-3000. The signals of 200 or more beats were averaged through the 40-300 Hz band-pass filter until the noise level was reduced to less than one microvolt (microV). The duration (fQRSd) and the root mean square voltage (LP40) for the last 40 msec of the filtered QRS complex were calculated. The left ventricular diastolic dimension (LVDd), systolic dimension (LVDs) and the ejection fraction (EF) were obtained by echocardiography. Five of 21 patients had VT. fQRSd was significantly longer in patients with VT than in those without VT (158.8 +/- 8.6 vs 126.5 +/- 10.4 msec, p < 0.01). LP40 was significantly less in patients with VT than in those without VT (8.7 +/- 2.7 vs 24.1 +/- 12.3 microV, p < 0.01). If the presence of "fQRSd > or = 120 msec" or "LP40 < or = 20 microV" was defined as VLP positive, as in patients with old myocardial infarction, the criteria sensitivity was 100% and their specificity was 25% for detecting VT. If the presence of both "fQRSd > or = 135 msec" and "LP40 < or = 20 microV" was defined as VLP positive, the criteria sensitivity was 100%, and their specificity, 88%.(ABSTRACT TRUNCATED AT 250 WORDS)
我们评估了心室晚电位(VLP)对检测室性心动过速(VT)的作用,以及VLP与左心室功能障碍之间的关系。研究对象包括21例不伴有心室传导障碍的扩张型心肌病(DCM)患者。使用VCM - 3000记录信号平均心电图。通过40 - 300Hz带通滤波器对200次或更多心跳的信号进行平均,直到噪声水平降低到小于1微伏(μV)。计算滤波后QRS波群最后40毫秒的时限(fQRSd)和均方根电压(LP40)。通过超声心动图获得左心室舒张末期内径(LVDd)、收缩末期内径(LVDs)和射血分数(EF)。21例患者中有5例发生VT。VT患者的fQRSd显著长于无VT患者(158.8±8.6对126.5±10.4毫秒,p<0.01)。VT患者的LP40显著低于无VT患者(8.7±2.7对24.1±12.3μV,p<0.01)。如同在陈旧性心肌梗死患者中一样,如果将“fQRSd≥120毫秒”或“LP40≤20μV”的存在定义为VLP阳性,那么检测VT的标准敏感性为100%,特异性为25%。如果将“fQRSd≥135毫秒”和“LP40≤20μV”同时存在定义为VLP阳性,标准敏感性为100%,特异性为88%。(摘要截断于250字)