平面 QRS-T 夹角>90 度与行冠状动脉造影术的患者多支冠状动脉疾病相关。

A planar QRS-T angle >90 degrees is associated with multivessel coronary artery disease in patients undergoing coronary angiography.

机构信息

Department of Medicine, Cardiology Division, New York Medical College, Valhalla, NY 10595, USA.

出版信息

Med Sci Monit. 2009 Dec;15(12):MS31-4.

PMID:19946243

Abstract

BACKGROUND

The aim of the study was to investigate the severity of coronary artery disease (CAD) in patients who had a planar QRS-T angle >90 degrees versus <or=90 degrees.

MATERIAL/METHODS: Coronary angiography was performed in 1,229 consecutive patients. Obstructive CAD was diagnosed if there was >50% obstruction of >or=1 major coronary artery. All QRS-T angle measurements were made from a 12-lead electrocardiogram by 2 authors who agreed on the measurement and who were blinded to the coronary angiographic findings. A QRS-T angle >90 degrees was considered abnormal.

RESULTS

Obstructive CAD of 2 or 3 vessels was present in 309 of 495 patients (62%) with a planar QRS-T angle >90 degrees and in 250 of 734 patients (34%) with a planar QRS-T angle <or=90 degrees . (p<0.0001). Stepwise logistic regression analyses showed that significant independent risk factors for 2- or 3-vessel CAD were age (odds ratio =1.05), male gender (odds ratio =1.8), black race (odds ratio =0.34), unstable angina (odds ratio =0.16), positive stress test (odds ratio =3.0), hypertension (odds ratio =3.0), dyslipidemia (odds ratio =2.9), QRS-T angle (odds ratio =7.2), left bundle branch block (odds ratio =2.9), right bundle branch block (odds ratio =0.17), smoking (odds ratio =9.7), and body mass index >or=30 kg/m2 (odds ratio =1.5).

CONCLUSIONS

The prevalence of 2- or 3-vessel obstructive CAD was significantly higher in patients with a planar QRS-T angle >90 degrees than in patients with a planar QRS-T angle <or=90 degrees (p<0.0001).

摘要

背景

本研究旨在探讨平面 QRS-T 角>90 度与<=90 度的患者中冠状动脉疾病（CAD）严重程度。

材料/方法：对 1229 例连续患者进行冠状动脉造影。如果>or=1 个主要冠状动脉的>50%阻塞，则诊断为阻塞性 CAD。由两位作者从 12 导联心电图中进行所有 QRS-T 角度测量，两位作者均同意该测量值，并且对冠状动脉造影结果均不知情。>90 度的 QRS-T 角被认为是异常的。

结果

在平面 QRS-T 角>90 度的 495 例患者中有 309 例（62%）和平面 QRS-T 角<=90 度的 734 例患者中有 250 例（34%）存在 2 或 3 支血管阻塞性 CAD。（p<0.0001）。逐步逻辑回归分析表明，2 或 3 支 CAD 的显著独立危险因素是年龄（优势比=1.05）、男性（优势比=1.8）、黑种人（优势比=0.34）、不稳定型心绞痛（优势比=0.16）、阳性应激试验（优势比=3.0）、高血压（优势比=3.0）、血脂异常（优势比=2.9）、QRS-T 角（优势比=7.2）、左束支传导阻滞（优势比=2.9）、右束支传导阻滞（优势比=0.17）、吸烟（优势比=9.7）和体重指数>or=30 kg/m2（优势比=1.5）。