心外因素对重症监护病房早期前壁心肌梗死患者信号平均心电图测量的晚电位的影响。

Effects of Extracardiac Factors in Signal-Averaged Electrocardiography-measured Late Potentials from Early Anterior Myocardial Infarction in Intensive Cardiac Care Unit.

机构信息

Internal Medicine Department, University of Indonesia.

出版信息

Acta Med Indones. 2020 Apr;52(2):131-139.

Abstract

BACKGROUND

one modality that can predict ventricular arrhythmias after myocardial infarction (MI), particularly anterior MI, is signal-averaged electrocardiogram (SA-ECG), through the detection of late potentials (LP) which is a substrate for ventricular arrhythmias. Extracardiac factors, which are also risk factors for MI, such as hypertension, diabetes, dyslipidemia, and obesity, are apparently associated with post-MI ventricular arrhythmias, which in turn may be correlated with LP. This study aims to determine the effect of extracardiac risk factors on LP incidence in anterior MI patients treated in the intensive cardiac care unit (ICCU).

METHODS

this was a cross-sectional study in which 80 subjects with anterior MI during the period of December 2018-2019 underwent SA-ECG examination. The medical history and extracardiac risk factors were recapitulated, and then the SA-ECG data was taken from either direct examination or ICCU patients' database in that period. This study used multivariate analysis with logistic regression test.

RESULTS

the most common factors found were hypertension (70.00%), followed by dyslipidemia (56.25%), diabetes (46.25%), and obesity (38.75%). Obesity and dyslipidemia are extracardiac factors with the two biggest roles in the prevalence of LP. However, from additional analysis, we found that diabetes with acute hyperglycemia also had immense influence on the occurrence of LP. The OR for diabetes with acute hyperglycemia, obesity, and dyslipidemia were 4.806 (IK95% 0.522-44.232), 4.291 (IK95% 0.469-39.299), and 3.237 (IK95% 0.560-18.707). However, the association is not statistically significant.

CONCLUSION

patients with anterior MI who suffer from diabetes with hyperglycemia in admission, obesity, and dyslipidemia have a potentially higher LP prevalence, despite statistical insignificance. To increase the prognostic value of SA-ECG, serial examinations are needed during hospitalization.

摘要

背景

一种可以预测心肌梗死后（MI），尤其是前壁 MI 室性心律失常的方法是信号平均心电图（SA-ECG），通过检测晚电位（LP）来预测室性心律失常，LP 是室性心律失常的基础。高血压、糖尿病、血脂异常和肥胖等也与 MI 相关的心脏外因素，显然与 MI 后室性心律失常有关，而 LP 可能与这些心律失常有关。本研究旨在确定心脏外危险因素对 ICU 治疗的前壁 MI 患者 LP 发生率的影响。

方法

这是一项横断面研究，纳入 2018 年 12 月至 2019 年期间的 80 例前壁 MI 患者，进行 SA-ECG 检查。回顾了患者的病史和心脏外危险因素，然后从直接检查或该期间 ICU 患者数据库中获取 SA-ECG 数据。本研究采用多元分析和逻辑回归检验。

结果

最常见的因素是高血压（70.00%），其次是血脂异常（56.25%）、糖尿病（46.25%）和肥胖（38.75%）。肥胖和血脂异常是心脏外因素，对 LP 发生率的影响最大。然而，进一步分析发现，伴有急性高血糖的糖尿病也对 LP 的发生有很大影响。糖尿病伴急性高血糖、肥胖和血脂异常的 OR 值分别为 4.806（95%CI 0.522-44.232）、4.291（95%CI 0.469-39.299）和 3.237（95%CI 0.560-18.707）。然而，这种关联没有统计学意义。