Muramoto David, Singh Nikhil, Aggarwal Sonya, Wong Myo, Adhikarla Chandana, Hadley David, Froelicher Victor
The Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
J Electrocardiol. 2013 Sep-Oct;46(5):427-33. doi: 10.1016/j.jelectrocard.2013.06.009. Epub 2013 Jul 16.
To augment data guiding thresholds for myocardial ischemia and cardiac risk, we studied resting ST amplitude in ambulatory patients and collegiate athletes.
We analyzed 4041 ECGs from ambulatory visits at the Veterans Affairs in Palo Alto, California from 1997 to 1999 and 1114 screening ECGs from Stanford University athletes in 2007-2008. Using the PR interval as the isoelectric line and >95μV and<-45μV (visually equivalent to 1mm and 0.5mm) to define ST elevation and depression, ST amplitude was measured at QRS-end.
ST elevation was most prevalent in males, African Americans, and athletes (87% of male athletes in anterior leads). ST depression was rare in athletes and, among patients, associated with time to cardiovascular death in lateral leads (age-adjusted HR of 1.9, p<0.001).
ST amplitude differs by gender, age, race, and athletic status, which should be considered when developing guidelines for ECG interpretation.
为增加指导心肌缺血及心脏风险阈值的数据，我们研究了门诊患者及高校运动员静息状态下的ST段幅度。
我们分析了1997年至1999年加利福尼亚州帕洛阿尔托退伍军人事务部门诊就诊的4041份心电图，以及2007 - 2008年斯坦福大学运动员的1114份筛查心电图。以PR间期作为等电位线，以>95μV和<-45μV（视觉上相当于1mm和0.5mm）来定义ST段抬高和压低，在QRS波终点测量ST段幅度。
ST段抬高在男性、非裔美国人及运动员中最为常见（前壁导联中87%的男性运动员出现ST段抬高）。ST段压低在运动员中少见，在患者中，与侧壁导联中心血管死亡时间相关（年龄校正后的风险比为1.9，p<0.001）。
ST段幅度因性别、年龄、种族及运动状态而异，在制定心电图解读指南时应予以考虑。
