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24小时动态心电图监测中的T波分析对心肌梗死患者主要不良心血管事件的预测评估:文献综述与未来展望

T-Wave Analysis on the 24 h Holter ECG Monitoring as a Predictive Assessment of Major Adverse Cardiovascular Events in Patients with Myocardial Infarction: A Literature Review and Future Perspectives.

作者信息

Duca Ștefania-Teodora, Roca Mihai, Costache Alexandru-Dan, Chetran Adriana, Afrăsânie Irina, Miftode Radu-Ștefan, Tudorancea Ionuț, Matei Iulian, Ciorap Radu-George, Mitu Ovidiu, Bădescu Minerva Codruța, Iliescu-Halitchi Dan, Halițchi-Iliescu Codruța-Olimpiada, Mitu Florin, Lionte Cătălina, Costache Irina-Iuliana

机构信息

Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.

Department of Cardiology, "St. Spiridon" Emergency County Hospital, 700111 Iasi, Romania.

出版信息

Life (Basel). 2023 May 10;13(5):1155. doi: 10.3390/life13051155.

Abstract

Myocardial ischemia is a pathophysiological state characterized by inadequate perfusion of the myocardium, resulting in an imbalance between myocardial oxygen demand and supply. It is most commonly caused by coronary artery disease, in which atherosclerotic plaques lead to luminal narrowing and reduced blood flow to the heart. Myocardial ischemia can manifest as angina pectoris or silent myocardial ischemia and can progress to myocardial infarction or heart failure if left untreated. Diagnosis of myocardial ischemia typically involves a combination of clinical evaluation, electrocardiography and imaging studies. Electrocardiographic parameters, as assessed by 24 h Holter ECG monitoring, can predict the occurrence of major adverse cardiovascular events in patients with myocardial ischemia, independent of other risk factors. The T-waves in patients with myocardial ischemia have prognostic value for predicting major adverse cardiovascular events, and their electrophysiological heterogeneity can be visualized using various techniques. Combining the electrocardiographic findings with the assessment of myocardial substrate may offer a better picture of the factors that can contribute to cardiovascular death.

摘要

心肌缺血是一种病理生理状态,其特征为心肌灌注不足,导致心肌氧供需失衡。它最常见的病因是冠状动脉疾病,其中动脉粥样硬化斑块会导致管腔狭窄并减少心脏的血流量。心肌缺血可表现为心绞痛或无症状性心肌缺血,如果不治疗,可进展为心肌梗死或心力衰竭。心肌缺血的诊断通常需要结合临床评估、心电图和影像学检查。通过24小时动态心电图监测评估的心电图参数可独立于其他危险因素预测心肌缺血患者发生主要不良心血管事件的风险。心肌缺血患者的T波对预测主要不良心血管事件具有预后价值,并且可以使用各种技术可视化其电生理异质性。将心电图结果与心肌基质评估相结合,可能会更好地了解导致心血管死亡的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb16/10222557/ab00d7c41b0a/life-13-01155-g001.jpg

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