仅在运动后恢复期出现的ST段压低评估中QRS波时限变化的意义。
Significance of QRS duration changes in the evaluation of ST-segment depression presenting exclusively during the postexercise recovery period.
作者信息
Michaelides Andreas P, Fourlas Christos A, Giannopoulos Nikolaos, Aggeli Konstantina, Andrikopoulos George K, Tsioufis Konstantinos, Massias Spiros S, Stefanadis Christodoulos I
机构信息
Department of A' Cardiology Clinic, Medical School of Athens University, Hippokration Hospital, Athens, Greece.
出版信息
Ann Noninvasive Electrocardiol. 2006 Jul;11(3):241-6. doi: 10.1111/j.1542-474X.2006.00110.x.
BACKGROUND
The aim of this study was to evaluate the contribution of QRS prolongation in the diagnosis of coronary artery disease (CAD) in patients with exercise-induced ST-segment depression exclusively during the recovery period.
METHODS
The study population consisted of 107 patients (90 males and 17 females) aged 39-70 (mean 59 +/- 7) years who underwent a treadmill exercise test using Bruce protocol and presented ST-segment depression limited to the recovery period. Angiographic data were available for all studied patients.
RESULTS
Among studied patients, 74 (69%) were found to have hemodynamically significant CAD, while the remaining 33 (31%) had normal coronary arteries. Concomitant QRS prolongation was revealed in 61 (82%) of the patients with angiographically documented CAD, while in 13 (18%) patients QRS duration remained unchanged. On the contrary, only 4 (12%) of the 33 patients with normal coronary arteries showed prolonged QRS duration during ST depression, while in the remaining 29 (88%) QRS duration remained unchanged.
CONCLUSIONS
The evaluation of the concomitant QRS duration changes may discriminate patients with truly ischemia-induced ST-segment depression limited to the recovery period.
背景
本研究旨在评估仅在恢复期出现运动诱发ST段压低的患者中QRS波增宽对冠状动脉疾病（CAD）诊断的贡献。
方法
研究人群包括107例年龄在39 - 70岁（平均59±7岁）的患者（90例男性和17例女性），他们接受了采用布鲁斯方案的平板运动试验，且ST段压低仅限于恢复期。所有研究患者均有血管造影数据。
结果
在研究患者中，74例（69%）被发现有血流动力学显著意义的CAD，而其余33例（31%）冠状动脉正常。在血管造影证实有CAD的患者中，61例（82%）伴有QRS波增宽，而13例（18%）患者的QRS时限保持不变。相反，在33例冠状动脉正常的患者中，只有4例（12%）在ST段压低时QRS时限延长，其余29例（88%）QRS时限保持不变。
结论
对伴随的QRS时限变化进行评估，可能有助于鉴别仅在恢复期出现真正缺血性诱发ST段压低的患者。
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