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高钾血症的一种新的心电图评估:额面QRS-T角

A new electrocardiographic evaluation in hyperkalemia: frontal QRS-T angle.

作者信息

Yedigoz Mustafa, Avci Akkan, Sener Kemal, Avci Begum S, Yesiloglu Onder, Urfalioglu Ahmet B, Aksay Erdem, Simsek Yeliz

机构信息

Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Türkiye.

Department of Emergency Medicine, Health Science University, Mersin City Research and Training Hospital, Mersin, Türkiye.

出版信息

Ir J Med Sci. 2025 Jun 21. doi: 10.1007/s11845-025-03988-3.

Abstract

INTRODUCTION

ECG is a frequently used and easily accessible diagnostic tool used to evaluate cardiac involvement in hyperkalemia patients.

OBJECTIVE

The present study aimed to investigate the mortality prediction potential of the frontal QRS-T angle in hyperkalemia patients and the effects of the treatment process on this angle.

METHOD

The study was planned as a prospective study. A total of 121 hyperkalemia patients were included in the study. Conditions that caused high potassium were identified and the PR, QRS, QT, QTc, and frontal QRS-T angle were calculated and recorded from the 12-lead ECG recordings of the patients at the time of admission to the emergency room.

RESULTS

The mean age of the patients was 58.5 ± 9.2 years (median: 59), 63 (% 52.1) were female and 58 (% 47.9) were male. The second measurements of the ECG parameters PR, QTc, QRS, T-amplitude, T duration, and frontal QRS-T values were lower than the first measurements (p < 0.001; p = 0.007; p < 0.001; p < 0.001; p < 0.001; p = 0.006, respectively). The ability of the patient's ECG parameters PR, QT, QTc, QRS, T-amplitude, frontal QRS-T angle, and frontal QRS-T (absolute value) to predict the development of mortality In the ROC Curve analysis, it was found that these parameters did not have a statistically significant effect in predicting mortality.

CONCLUSION

As well as known ECG findings, in cases of hyperkalemia, widening of the frontal QRS-T angle and correction of this widened angle in patients with normokalemia detected with treatment can be used as an important follow-up parameter.

摘要

引言

心电图是一种常用且易于获取的诊断工具,用于评估高钾血症患者的心脏受累情况。

目的

本研究旨在探讨额面QRS-T角对高钾血症患者的死亡预测潜力以及治疗过程对该角度的影响。

方法

本研究计划为前瞻性研究。共纳入121例高钾血症患者。确定导致血钾升高的情况,并在患者急诊入院时从12导联心电图记录中计算并记录PR、QRS、QT、QTc和额面QRS-T角。

结果

患者的平均年龄为58.5±9.2岁(中位数:59岁),女性63例(52.1%),男性58例(47.9%)。心电图参数PR、QTc、QRS、T波振幅、T波时限和额面QRS-T值的第二次测量低于第一次测量(p<0.001;p=0.007;p<0.001;p<0.001;p<0.001;p=0.006)。在ROC曲线分析中,患者的心电图参数PR、QT、QTc、QRS、T波振幅、额面QRS-T角和额面QRS-T(绝对值)预测死亡发生的能力,发现这些参数在预测死亡率方面没有统计学显著影响。

结论

除了已知的心电图表现外,在高钾血症病例中,额面QRS-T角增宽以及治疗后检测到的血钾正常患者中该增宽角度的纠正可作为重要的随访参数。

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