Perez-Alday Erick A, Hamilton Christopher, Li-Pershing Annabel, Monroy-Trujillo Jose M, Estrella Michelle, Sozio Stephen M, Jaar Bernard, Parekh Rulan, Tereshchenko Larisa
Oregon Health & Science University, Portland, OR, USA.
Johns Hopkins University, Baltimore, MD, USA.
Comput Cardiol (2010). 2018 Sep;45. doi: 10.22489/cinc.2018.162. Epub 2019 Jun 24.
Global electrical heterogeneity (GEH) is a useful predictor of adverse clinical outcomes. However, reproducibility of GEH measurements on 10-second routine clinical ECG is unknown.
Data of the prospective cohort study of incident hemodialysis patients (n=253; mean age 54.6±13.5y; 56% male; 79% African American) were analysed. Two random 10-second segments of 5-minute ECG recording in sinus rhythm were compared. GEH was measured as spatial QRS-T angle, spatial ventricular gradient (SVG) magnitude and direction (azimuth and elevation), and a scalar value of SVG measured by (1) sum absolute QRST integral (SAI QRST), and (2) QT integral on vector magnitude signal (iVM). Bland-Altman analysis was used to calculate agreement.
For all studied vectorcardiographic metrics, agreement was substantial (Lin's concordance coefficient >0.98), and precision was perfect (>99.99%). 95% limits of agreement were ±14° for spatial QRS-T angle, ±13° for SVG azimuth, ±4° for SVG elevation, ±14 mVms for SVG magnitude, and ±17 mVms for SAI QRST. SAI QRST and iVM were in substantial agreement with each other.
Reproducibility of a 10-second automated GEH ECG measurements was substantial, and precision was perfect.
整体电不均一性（GEH）是不良临床结局的一个有用预测指标。然而，10秒常规临床心电图上GEH测量的可重复性尚不清楚。
对 incident 血液透析患者（n = 253；平均年龄54.6±13.5岁；56%为男性；79%为非裔美国人）的前瞻性队列研究数据进行分析。比较窦性心律下5分钟心电图记录中的两个随机10秒片段。GEH通过空间QRS - T角、空间心室梯度（SVG）大小和方向（方位角和仰角）以及通过（1）绝对QRST积分总和（SAI QRST）和（2）向量大小信号上的QT积分（iVM）测量的SVG标量值来测量。采用Bland - Altman分析计算一致性。
对于所有研究的向量心电图指标，一致性良好（Lin一致性系数>0.98），精密度极佳（>99.99%）。空间QRS - T角的95%一致性界限为±14°，SVG方位角为±13°，SVG仰角为±4°，SVG大小为±14 mVms，SAI QRST为±17 mVms。SAI QRST和iVM彼此之间一致性良好。
10秒自动GEH心电图测量的可重复性良好，精密度极佳。
