心电图T波倒置对心肌梗死后患者预后的影响。
Effects of negative T wave in electrocardiography on prognosis of post-myocardial infarction patients.
作者信息
Karbasi-Afshar Reza, Jonaidi-Jafari Nematollah, Saburi Amin, Motamedi Mohammad Reza
机构信息
Assistant Professor, Department of Cardiovascular Diseases, School of Medicine, Tehran And Cardiovascular Research Center.
出版信息
ARYA Atheroscler. 2013 Mar;9(2):128-33.
BACKGROUND
Negative T (NT) wave in electrocardiography (ECG) is one of the important factors in determining short- and long-term outcomes in patients with acute myocardial infarction (MI). In this study, we compared clinical and paraclinical findings in post-MI patients according to presence or absence of NT wave.
METHODS
A cross-sectional study was conducted on patients with acute ST elevation MI who presented to Shahid Modares Hospital (Tehran, Iran) during 2009-10. After undergoing streptokinase therapy, demographic characteristics and ECG and exercise test findings of the subjects were compared based on the presence or absence of NT wave.
RESULTS
Overall, 116 patients including 69 cases with NT wave (NT group) and 47 cases without NT wave (PT group) were enrolled (mean age: 53.7 ± 7.1 vs. 54.1 ± 6.8 years old). Mortality rate during the first five days was 13% in the NT group and 29% in the PT group (P < 0.05). Ejection fraction values of the NT group were significantly higher than the PT group (P = 0.005). However, left ventricular end-diastolic diameter of the NT group was significantly less than the PT group (P = 0.005). Moreover, ST segment depression was significantly less frequent in the NT group compared to the PT group.
CONCLUSION
Patients with ST elevation MI accompanying with NT wave in ECG versus have better prognosis and myocardial function than similar patients without NT wave. Therefore, invasive procedures should be recommended for patients without NT wave.
背景
心电图（ECG）中的负向T波（NT波）是决定急性心肌梗死（MI）患者短期和长期预后的重要因素之一。在本研究中，我们根据有无NT波比较了心肌梗死后患者的临床和辅助检查结果。
方法
对2009年至2010年期间在伊朗德黑兰沙希德·莫达雷斯医院就诊的急性ST段抬高型心肌梗死患者进行了一项横断面研究。在接受链激酶治疗后，根据有无NT波比较受试者的人口统计学特征、心电图和运动试验结果。
结果
总共纳入了116例患者，其中69例有NT波（NT组），47例无NT波（PT组）（平均年龄：53.7±7.1岁对54.1±6.8岁）。NT组前五天的死亡率为13%，PT组为29%（P<0.05）。NT组的射血分数值显著高于PT组（P=0.005）。然而，NT组的左心室舒张末期直径显著小于PT组（P=0.005）。此外，NT组的ST段压低发生率明显低于PT组。
结论
与无NT波的类似患者相比，心电图伴有NT波的ST段抬高型心肌梗死患者预后和心肌功能更好。因此，对于无NT波的患者应推荐进行侵入性检查。
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