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非 ST 段抬高型急性冠状动脉综合征患者 P 波峰时间与冠状动脉病变严重程度的关系。

Relationship between P wave peak time and coronary artery disease severity in non-ST elevation acute coronary syndrome.

机构信息

Depertament of Cardiology, Umraniye Training and Research Hospital, University of Medical Sciences, Umraniye, Turkey.

Depertament of Cardiology, Faculty of Medicine, Hitit University, Buharaevler Mah. Buhara 25. Sok. No. 1 /A Daire: 22, Çorum, Turkey.

出版信息

Herz. 2021 Mar;46(2):188-194. doi: 10.1007/s00059-019-04859-1. Epub 2019 Oct 2.

Abstract

BACKGROUND

Early diagnosis of non-ST elevation acute coronary syndrome (NSTE-ACS) and prediction of the severity of current coronary artery disease (CAD) play a major role in patient prognosis. Electrocardiography has a unique value in the diagnosis and provides prognostic information on patients with NSTE-ACS. In the present study, we aimed to examine the relationship between P wave peak time (PWPT) and the severity of CAD in patients with NSTE-ACS.

METHODS

A total of 132 consecutive patients (female: 35.6%; mean age: 60.1 ± 11.6 years) who were diagnosed with NSTE-ACS were evaluated retrospectively. Gensini scores (GSs) were used to define the angiographic characteristics of the coronary atherosclerotic lesions. The patients were divided into two groups according to the GS. The PWPT was defined as the duration between the beginning and the peak of the P wave, and R wave peak time (RWPT) was defined as the duration between the beginning of the QRS complex and the peak of the R wave.

RESULTS

There were 59 (44.6%) patients in the high-GS group (GS ≥25 ) and 73 (55.3%) patients in the low-GS group (GS <25 ). Presence of diabetes mellitus, low left ventricular ejection fraction, and high RWPT and PWPT were identified as predictors of a high GS in the study population. There was no significant difference between the area under the curves of PWPT and RWPT for predicting the severity of CAD (0.663 vs. 0.623, respectively; p = 0.573).

CONCLUSION

The present study found that both PWPT and RWPT on admission electrocardiography were associated with the severity and complexity of CAD in patients with NSTE-ACS.

摘要

背景

非 ST 段抬高型急性冠状动脉综合征(NSTE-ACS)的早期诊断和当前冠状动脉疾病(CAD)严重程度的预测对患者预后具有重要作用。心电图在诊断中具有独特的价值,并为 NSTE-ACS 患者提供预后信息。在本研究中,我们旨在研究 NSTE-ACS 患者 P 波峰时间(PWPT)与 CAD 严重程度之间的关系。

方法

回顾性评估了 132 例连续确诊为 NSTE-ACS 的患者(女性:35.6%;平均年龄:60.1±11.6 岁)。使用 Gensini 评分(GS)定义冠状动脉粥样硬化病变的血管造影特征。根据 GS 将患者分为两组。PWPT 定义为 P 波起点与波峰之间的持续时间,R 波峰时间(RWPT)定义为 QRS 波群起点与 R 波峰之间的持续时间。

结果

高 GS 组(GS≥25)有 59 例(44.6%)患者,低 GS 组(GS<25)有 73 例(55.3%)患者。研究人群中,存在糖尿病、左心室射血分数低、RWPT 和 PWPT 高被确定为 GS 高的预测因素。PWPT 和 RWPT 预测 CAD 严重程度的曲线下面积无显著差异(分别为 0.663 和 0.623;p=0.573)。

结论

本研究发现,NSTE-ACS 患者入院时心电图的 PWPT 和 RWPT 均与 CAD 的严重程度和复杂性相关。

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