Wang Shuang-Shuang, Yi Xiu-Ying, Ji Qing, Wang Yu-Wen, Wang Cheng
Department of Pediatric Cardiovasology, Children's Medical Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Nov;21(11):1084-1088. doi: 10.7499/j.issn.1008-8830.2019.11.006.
To study the change in P wave on electrocardiogram and its diagnostic value in children and adolescents with cardioinhibitory vasovagal syncope (VVS-CI).
A total of 43 children and adolescents who were diagnosed with VVS-CI were enrolled as the VVS-CI group, and 43 healthy children and adolescents were enrolled as the control group. P wave duration and P wave voltage were measured by 12-lead electrocardiography in a basal state, and the changes were analyzed.
Compared with the control group, the VVS-CI group had a significantly lower heart rate (P<0.05) and significantly longer P wave duration (Pwd), P wave maximum duration (Pmax), and corrected P wave maximum duration (Pcmax), as well as significantly higher P wave dispersion (Pd) and corrected P wave dispersion (Pcd) (P<0.05). Pwd, Pmax, Pd, Pcmax and Pcd had a certain diagnostic value in children and adolescents with VVS-CI (P<0.05): Pwd had a sensitivity of 69.77% and a specificity of 83.72% at the optimal cut-off value of 78.49 ms; Pmax had a sensitivity of 76.74% and a specificity of 90.70% at the optimal cut-off value of 93.39 ms; Pd had a sensitivity of 95.35% and a specificity of 69.77% at the optimal cut-off value of 27.42 ms; Pcmax had a sensitivity of 46.51% and a specificity of 88.37% at the optimal cut-off value of 120.90 ms; Pcd had a sensitivity of 83.72% and a specificity of 72.09% at the optimal cut-off value of 36.37 ms.
Children and adolescents with VVS-CI have significantly increased Pwd, Pmax, Pd, Pcmax, and Pcd, which may indicate abnormal atrial electrical activity. The cut-off value of P wave has a certain diagnostic value in VVS-CI.
研究心电图P波变化及其对儿童和青少年心脏抑制型血管迷走性晕厥(VVS-CI)的诊断价值。
共纳入43例诊断为VVS-CI的儿童和青少年作为VVS-CI组,43例健康儿童和青少年作为对照组。采用12导联心电图在基础状态下测量P波时限和P波电压,并分析其变化。
与对照组相比,VVS-CI组心率显著降低(P<0.05),P波时限(Pwd)、P波最大时限(Pmax)、校正P波最大时限(Pcmax)显著延长,P波离散度(Pd)和校正P波离散度(Pcd)显著升高(P<0.05)。Pwd、Pmax、Pd、Pcmax和Pcd对儿童和青少年VVS-CI有一定诊断价值(P<0.05):在最佳截断值78.49 ms时,Pwd的敏感性为69.77%,特异性为83.72%;在最佳截断值93.39 ms时,Pmax的敏感性为76.74%,特异性为90.70%;在最佳截断值27.42 ms时,Pd的敏感性为95.35%,特异性为69.77%;在最佳截断值120.90 ms时,Pcmax的敏感性为46.51%,特异性为88.37%;在最佳截断值36.37 ms时,Pcd的敏感性为83.72%,特异性为72.09%。
VVS-CI儿童和青少年的Pwd、Pmax、Pd、Pcmax和Pcd显著增加,这可能提示心房电活动异常。P波截断值对VVS-CI有一定诊断价值。