González-Juanatey J R, Pose Reino A, García-Acuña J M, Trillo Nouche R, Amaro Cendón A, Gil de la Peña M
Servicio de Cardiología, Hospital Xeral de Galicia, Clínico Universitario, Santiago de Compostela, La Coruña.
Med Clin (Barc). 1995 May 20;104(19):732-6.
ECG ST-T segment abnormalities in hypertensive patients are traditionally associated with hypertrophy or ischaemia. Hypertensive patients with abnormalities in ST-T segment in DI, aVL and/or V5-V6 underwent an echocardiographic study in order to assess left ventricular structure. All of them, in addition to the electric changes, showed typical or non-typical thoracic discomfort, showing a normal coronariographic study.
Hypertensive patients with ST-T segment changes were classified as follows: group A, 12 patients (8 women, 4 men, mean age 63.6 +/- 7.2 years) with ECG image of left ventricular overload pattern; group B, 9 patients (3 men, 6 women, mean age 62.3 +/- 6.3 years) with flat ST segment depression; and group C, 10 patients (3 men, 7 women, mean age 62.4 +/- 9.7 years) without changes on the ST-T segment with flat or negative T wave. Control group is made up 12 hypertensive patients (7 women, 5 men, mean age 61.6 +/- 7.6 years) with normal ECG. We assess by echocardiography interventricular septal thickness (IVST) and left ventricular posterior wall thickness (PWT) in mm, left ventricular end-diastolic diameter (DTD) in mm, left ventricular mass (LVM) in grs, and the mass index (MI) in g/m2.
IVST, PWT, LVM and MI were significantly (p < 0.05) higher in the groups A, B and C than in the control group. No statistically significant differences were observed between the A, B and C groups. Stepwise discriminant analysis showed that the only parameter with independent value for discriminating between control, group and group ABC (the union of groups A, B and C) was IVST.
In hypertensive patients without coronariopathy, ST-T changes identify a group with greater left ventricular mass. The different electrocardiographic patterns considered were not associated with a significantly different left ventricular mass.
高血压患者的心电图ST - T段异常传统上与心肌肥厚或缺血有关。对在DI、aVL和/或V5 - V6导联出现ST - T段异常的高血压患者进行了超声心动图研究，以评估左心室结构。他们所有人除了有电学改变外，还表现出典型或非典型的胸部不适，但冠状动脉造影检查正常。
将有ST - T段改变的高血压患者分为以下几组：A组，12例患者（8名女性，4名男性，平均年龄63.6±7.2岁），心电图表现为左心室负荷过重模式；B组，9例患者（3名男性，6名女性，平均年龄62.3±6.3岁），ST段呈平坦型压低；C组，10例患者（3名男性，7名女性，平均年龄62.4±9.7岁），ST - T段无改变，T波平坦或倒置。对照组由12例心电图正常的高血压患者（7名女性，5名男性，平均年龄61.6±7.6岁）组成。我们通过超声心动图评估室间隔厚度（IVST）和左心室后壁厚度（PWT），单位为毫米，左心室舒张末期直径（DTD），单位为毫米，左心室质量（LVM），单位为克，以及质量指数（MI），单位为克/平方米。
A组、B组和C组的IVST、PWT、LVM和MI均显著高于对照组（p < 0.05）。A组、B组和C组之间未观察到统计学上的显著差异。逐步判别分析表明，用于区分对照组与A、B、C组（A、B、C组的联合）的唯一具有独立价值的参数是IVST。
在无冠心病的高血压患者中，ST - T改变可识别出左心室质量较大的一组患者。所考虑的不同心电图模式与左心室质量的显著差异无关。
