Vesterinen Paula, Väänänen Heikki, Hänninen Helena, Korhonen Petri, Tierala Ilkka, Husa Terhi, Mäkijärvi Markku, Toivonen Lauri
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland.
Cardiology. 2008;109(4):222-9. doi: 10.1159/000107784. Epub 2007 Sep 17.
Conventionally, the detection of prior myocardial infarction (MI) is based on QRS abnormalities, which may ignore non-Q-wave MI (NQMI). We aimed at finding automatically applicable quantitative ECG variables for diagnosing prior MI.
Body surface potential mapping (BSPM) was registered and automatically analyzed in 144 patients with prior MI and in 75 healthy controls. The MI was defined according to its age as recent or old, and Q-wave status as Q-wave MI (QMI) or NQMI.
The QRSSTT integral, the STT integral and the T-wave apex amplitude applied in single, selected leads were found to be the optimal parameters in the detection of prior MI. The areas under the receiver-operating characteristic curves (AUC) were 89% for each, and detection was equal in old and recent MI (AUCs from 87 to 90%), and in QMI and NQMI (AUCs from 88 to 90%).
The quantitative, automatically applicable single-lead variables comprising ventricular repolarization was effective in detecting prior MI, irrespective of the time elapsed from MI or the Q-wave status. These variables could be suitable for population studies and health screening purposes and are applicable to automatic ECG diagnostics of prior MI.
传统上，既往心肌梗死（MI）的检测基于QRS波异常，这可能会忽略非Q波心肌梗死（NQMI）。我们旨在寻找可自动应用的定量心电图变量来诊断既往心肌梗死。
对144例既往心肌梗死患者和75例健康对照者进行体表电位标测（BSPM）并自动分析。根据心肌梗死的发生时间将其定义为近期或陈旧性，根据Q波情况定义为Q波心肌梗死（QMI）或NQMI。
发现在单个选定导联中应用的QRSSTT积分、STT积分和T波顶点振幅是检测既往心肌梗死的最佳参数。每个参数的受试者工作特征曲线下面积（AUC）均为89%，在陈旧性和近期心肌梗死中的检测效果相同（AUC为87%至90%），在QMI和NQMI中的检测效果也相同（AUC为88%至90%）。
包含心室复极的定量、可自动应用的单导联变量在检测既往心肌梗死方面有效，无论心肌梗死后经过的时间或Q波情况如何。这些变量适用于人群研究和健康筛查目的，可应用于既往心肌梗死的自动心电图诊断。
