Pollak S J, Kertes P J, Bredlau C E, Walter P F
Am Heart J. 1985 Oct;110(4):747-52. doi: 10.1016/0002-8703(85)90452-1.
Left ventricular dysfunction has been suggested as a cause of late potentials on the signal averaged ECG of patients with coronary artery disease. We compared the averaged surface ECG with angiographic findings in 57 patients with coronary artery disease and left ventricular dysfunction. Sixteen patients had sustained ventricular tachycardia and 41 had no documented arrhythmia. These two patient groups were comparable with respect to age, mean ejection fraction, and wall motion score. Late potentials, defined as voltage less than 25 microV in the last 40 msec of the filtered QRS complex, were found in 10 of 16 patients with ventricular tachycardia and in 6 of 41 patients without arrhythmia (p less than 0.005). However, late potentials were independent of ejection fraction, wall motion score, or presence of dyskinesis in both groups. There was no correlation between the total filtered QRS duration and ejection fraction or wall motion score in either patient group. In patients with coronary artery disease, late potentials are associated with ventricular tachycardia but are independent of global or regional left ventricular function. This finding has important implications for studies of the prognostic value of late potentials following myocardial infarction.
左心室功能障碍被认为是冠状动脉疾病患者信号平均心电图上出现晚电位的一个原因。我们比较了57例冠状动脉疾病伴左心室功能障碍患者的平均体表心电图和血管造影结果。16例患者有持续性室性心动过速，41例无心律失常记录。这两组患者在年龄、平均射血分数和室壁运动评分方面具有可比性。晚电位定义为滤波后的QRS波群最后40毫秒内电压小于25微伏，在16例室性心动过速患者中有10例出现，在41例无心律失常患者中有6例出现（p<0.005）。然而，两组中晚电位均与射血分数、室壁运动评分或运动障碍的存在无关。在任一患者组中，总滤波QRS时限与射血分数或室壁运动评分之间均无相关性。在冠状动脉疾病患者中，晚电位与室性心动过速相关，但与左心室整体或局部功能无关。这一发现对心肌梗死后晚电位预后价值的研究具有重要意义。
