Tanaka T
First Department of Internal Medicine, Nippon Medical School.
Nihon Ika Daigaku Zasshi. 1991 Aug;58(4):50-60.
To know the relationship between positive ventricular late potentials (LP) and occurrence of ventricular tachycardia (VT), signal-averaged electrocardiogram (SAECG) was recorded in 214 patients with myocardial infarction (MI). According to the time course of SAECG recording after the onset of MI, the subjects were divided into three groups; acute MI (AMI) group (onset-2nd week, n = 148), recent MI (RMI) group (3rd-6th week, n = 19) and old MI (OMI) group (7th week or later, n = 47). The incidence of positive LP in each group was 22.3%, 36.8% and 12.8%, respectively. VT was observed in 51.5% (AMI), 71.4% (RMI) and 83.3% (OMI) in LP positive patients, and these proportions were significantly higher than those (25.2%, 0% and 9.8%) in LP negative patients. Sensitivity, specificity and predictive accuracy of positive LP to predict occurrence of VT were 37.0%, 84.3% and 69.7% in AMI, 100%, 85.7% and 89.5% in RMI and 55.6%, 97.4% and 89.5% in OMI, respectively. Incidence of positive LP in the patients with inferior infarction (23.9%) or with combination of inferior and anterior infarction (60.0%) were significantly higher than those in patients with anterior infarction alone (13.9%). Significantly higher peak-CPK value (4333 +/- 2580 IU/L) in the patients with positive LP compared to those with negative LP (2438 +/- 2023 IU/L) suggests that patients with positive LP have an infarction of larger size. In conclusion, non-invasive LP detection using signal averaging technique was useful in prediction of occurrence of VT in patients with MI in any phase.
为了解心室晚电位（LP）阳性与室性心动过速（VT）发生之间的关系，对214例心肌梗死（MI）患者进行了信号平均心电图（SAECG）记录。根据MI发作后SAECG记录的时间进程，将受试者分为三组：急性心肌梗死（AMI）组（发作至第2周，n = 148）、近期心肌梗死（RMI）组（第3至6周，n = 19）和陈旧性心肌梗死（OMI）组（第7周及以后，n = 47）。每组中LP阳性的发生率分别为22.3%、36.8%和12.8%。LP阳性患者中VT的发生率在AMI组为51.5%、RMI组为71.4%、OMI组为83.3%，这些比例显著高于LP阴性患者（分别为25.2%、0%和9.8%）。LP阳性预测VT发生的敏感性、特异性和预测准确性在AMI组分别为37.0%、84.3%和69.7%，在RMI组分别为100%、85.7%和89.5%，在OMI组分别为55.6%、97.4%和89.5%。下壁梗死患者（23.9%）或下壁合并前壁梗死患者（60.0%）中LP阳性的发生率显著高于单纯前壁梗死患者（13.9%）。LP阳性患者的肌酸磷酸激酶峰值（4333±2580 IU/L）显著高于LP阴性患者（2438±2023 IU/L），这表明LP阳性患者梗死面积更大。总之，使用信号平均技术进行无创LP检测有助于预测MI各阶段患者VT的发生。
