Chen Haichao, Cao Yiwei, Liang Lei, Gao Yan, Feng Jing, Zhang Le, Shi Lingxia, Chang Fengjun, Cheng Gong, Wu Haoyu
Department of Cardiology, Shaanxi Provincial People's Hospital, Xi'an, China.
Department of Electrocardiology, Shaanxi Provincial People's Hospital, Xi'an, China.
SAGE Open Med. 2024 Aug 27;12:20503121241272661. doi: 10.1177/20503121241272661. eCollection 2024.
The cause of syncope is generally determined based on clinical manifestations. There has been little discussion about the value of electrocardiograms for diagnosing neurally mediated syncope. The aim of this study was to test the predictive value of the isolated very low QRS voltage in tilt-table testing for suspected neurally mediated syncope in a Chinese population.
This retrospective study enrolled patients with suspected neurally mediated syncope. Tilt-table testing was a part of the diagnostic examination. Each patient underwent echocardiography and electrocardiogram. isolated very low QRS voltage referred to a voltage of ⩽0.3 mV for the QRS complex in an isolated frontal lead or ⩽0.7 mV for the QRS complex in an isolated precordial lead.
In total, 157 patients were included in the tilt-table testing positive group, and 242 patients were included in the tilt-table testing negative group. Compared with the testing negative group, the testing positive group had more patients with isolated very low QRS voltage in the frontal leads ( < 0.001). Moreover, for patients with isolated very low QRS voltage in the precordial leads, no significant difference was noted between the testing positive group and testing negative group ( = 0.289). Isolated very low QRS voltage in the frontal leads demonstrated 84.08% sensitivity and 74.38% specificity for a positive tilt-table testing response. The area under the curve of isolated very low QRS voltage for a positive tilt-table testing response in frontal leads was 0.806 ( < 0.0001).
In patients with suspected neurally mediated syncope, isolated very low QRS voltage in the frontal leads is a parameter that can predict a positive tilt-table testing response. The presence of isolated very low QRS voltage in frontal leads can serve as a parameter for evaluating syncope patients.
晕厥病因一般根据临床表现来确定。关于心电图对神经介导性晕厥的诊断价值，此前鲜有讨论。本研究旨在检验中国人群中，倾斜试验时单纯极低QRS电压对疑似神经介导性晕厥的预测价值。
这项回顾性研究纳入了疑似神经介导性晕厥的患者。倾斜试验是诊断检查的一部分。每位患者均接受了超声心动图和心电图检查。单纯极低QRS电压是指单份额面导联QRS波群电压≤0.3mV，或单份胸前导联QRS波群电压≤0.7mV。
倾斜试验阳性组共纳入157例患者，倾斜试验阴性组共纳入242例患者。与试验阴性组相比，试验阳性组额面导联单纯极低QRS电压的患者更多（P<0.001）。此外，对于胸前导联单纯极低QRS电压的患者，试验阳性组与试验阴性组之间未观察到显著差异（P=0.289）。额面导联单纯极低QRS电压对倾斜试验阳性反应的敏感性为84.08%，特异性为74.38%。额面导联单纯极低QRS电压对倾斜试验阳性反应的曲线下面积为0.806（P<0.0001）。
在疑似神经介导性晕厥的患者中，额面导联单纯极低QRS电压是预测倾斜试验阳性反应的一个参数。额面导联存在单纯极低QRS电压可作为评估晕厥患者的一个参数。
