Pipberger H V, Doyle J T, Schlesselman S, Pipberger H A, Halperin M, McManus C D, Appel M, Yamamoto W S
J Electrocardiol. 1986 Oct;19(4):327-36. doi: 10.1016/s0022-0736(86)81060-3.
In a prospective study on Coronary Heart Disease (CHD) orthogonal electrocardiograms (Frank) were recorded annually for ten years from 1,444 asymptomatic, middle-aged males with a mean age of 57.4 +/- 10.6 years. Cases with overt or suspected CHD were excluded. The purpose of the study was to identify risk indicators in electrocardiograms and to compare them with other known risk factors used for prediction of acute CHD events such as myocardial infarction (MI) and/or cardiac death (CD). Such acute events occurred in 88 cases. Pre-event ECGs of these acute events were compared with all others without events, using logistic regression analysis. Identified ECG risk indicators were then compared with other known risk factors such as smoking, blood pressure, cholesterol, age, weight, etc. The predictive power of the ECG, derived mainly from the ST-T complex, exceeded all others by a wide margin. The amplitude of the first 1/8 of the ST-T complex in lead x (similar to V5-V6) together with relative body weight proved best when one pre-event record was available. Prediction improved when ECG changes between two pre-event recordings were included. Precision of measurements by computer appeared essential for improvements in CHD prediction.
在一项关于冠心病（CHD）的前瞻性研究中，对1444名平均年龄为57.4±10.6岁的无症状中年男性进行了为期十年的年度正交心电图（Frank导联）记录。排除了患有明显或疑似冠心病的病例。该研究的目的是识别心电图中的风险指标，并将其与用于预测急性冠心病事件（如心肌梗死（MI）和/或心源性死亡（CD））的其他已知风险因素进行比较。此类急性事件发生在88例患者中。使用逻辑回归分析，将这些急性事件发生前的心电图与所有未发生事件的心电图进行比较。然后将识别出的心电图风险指标与其他已知风险因素（如吸烟、血压、胆固醇、年龄、体重等）进行比较。主要源自ST-T复合波的心电图预测能力远远超过其他所有因素。当有一份事件发生前的记录时，x导联（类似于V5-V6）中ST-T复合波前1/8的振幅与相对体重结合起来效果最佳。当纳入两次事件发生前记录之间的心电图变化时，预测效果有所改善。计算机测量的精度对于改善冠心病预测似乎至关重要。
