Kurisu Satoshi, Nitta Kazuhiro, Sumimoto Yoji, Ikenaga Hiroki, Ishibashi Ken, Fukuda Yukihiro, Kihara Yasuki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, 1-2-3, Kasumi-cho, Minami-ku, Hiroshima, 734-8551, Japan.
Heart Vessels. 2019 Jun;34(6):971-975. doi: 10.1007/s00380-018-01330-9. Epub 2019 Jan 2.
The frontal QRS-T angle is one of the markers of ventricular repolarization. We sought to assess the effects of myocardial perfusion defect on QRS-T angle in patients with prior anterior myocardial infarction (MI). Seventy-one patients with prior anterior MI and 71 age- and sex-matched control subjects having no myocardial perfusion defect were selected. Frontal QRS-T angle was defined as the absolute value of the difference between the frontal plane QRS axis and T-wave axis. The extent of myocardial perfusion defect was determined using myocardial perfusion single-photon emission computed tomography (SPECT). The extent of myocardial perfusion defect of patients with prior anterior MI was 21.8 ± 13.7%. Frontal QRS-T angle was significantly larger in patients with prior anterior MI than control subjects (82° ± 49° vs 30° ± 26°, p < 0.001). Prevalence of abnormal frontal QRS-T angle defined as more than 90° was significantly higher in patients with prior anterior MI than control subjects (42% vs 4%, p < 0.001). Multivariate linear regression analysis showed that age (β=0.18, p = 0.02) and myocardial perfusion defect (β = 0.46, p = 0.02) were independent determinants of frontal QRS-T angle. Our results suggest that the extent of myocardial perfusion defect is an independent determinant of frontal QRS-T angle in patients with prior anterior MI.
额面QRS-T夹角是心室复极的标志物之一。我们旨在评估既往前壁心肌梗死（MI）患者心肌灌注缺损对QRS-T夹角的影响。选取71例既往有前壁MI的患者以及71例年龄和性别匹配、无心肌灌注缺损的对照者。额面QRS-T夹角定义为额面QRS电轴与T波电轴差值的绝对值。采用心肌灌注单光子发射计算机断层扫描（SPECT）测定心肌灌注缺损程度。既往有前壁MI患者的心肌灌注缺损程度为21.8±13.7%。既往有前壁MI患者的额面QRS-T夹角显著大于对照者（82°±49°对30°±26°，p<0.001）。定义为大于90°的异常额面QRS-T夹角在既往有前壁MI患者中的患病率显著高于对照者（42%对4%，p<0.001）。多因素线性回归分析显示，年龄（β=0.18，p=0.02）和心肌灌注缺损（β=0.46，p=0.02）是额面QRS-T夹角的独立决定因素。我们的结果提示，心肌灌注缺损程度是既往有前壁MI患者额面QRS-T夹角的独立决定因素。
