Kawakami Y, Sakai Y, Kawamura K
Department of Internal Medicine, Osaka Medical College.
Nihon Rinsho. 1995 Jan;53(1):219-24.
To evaluate the diagnostic usefulness and prognostic significance of QRST isointegral map in dilated cardiomyopathy (DCM), we performed body surface mapping, signal averaged electrocardiogram and thallium-201 myocardial scintigraphy in 41 DCM patients. Late potentials (LP) were detected in 17 patients (41%). QRST isointegral subtraction map (QRST I-sub map: departure map, calculated from 40 normal subjects) showed -2 standard deviation area and departure indices at minimal point (DImin) were calculated in each case. Significant coefficients of correlation were observed between the DImin and root mean square voltage in last 40 ms (r = -0.435, p < 0.001). The abnormal scintigraphic patterns were discriminated into 3 groups: anteroseptal, inferoapical and posterolateral defects, which revealed separate distribution of minimal point in QRST I-sub map: F-G 4, G-H 2 and I-J 4, respectively. These results suggest that QRST isointegral map is useful for detecting the presence of LP (prognostic value) and the location of scintigraphic perfusion defect (diagnostic value) in DCM.
为评估QRST等积分图在扩张型心肌病（DCM）中的诊断价值及预后意义，我们对41例DCM患者进行了体表标测、信号平均心电图及铊-201心肌闪烁显像检查。17例患者（41%）检测到晚期电位（LP）。QRST等积分减法图（QRST I-减图：由40名正常受试者计算得出的偏差图）显示了-2标准差区域，并计算了各病例最低点的偏差指数（DImin）。DImin与最后40毫秒的均方根电压之间观察到显著的相关性系数（r = -0.435，p < 0.001）。异常闪烁显像模式分为3组：前间隔、下尖部和后外侧缺损，其在QRST I-减图中最低点的分布分别为：F-G 4、G-H 2和I-J 4。这些结果表明，QRST等积分图有助于检测DCM中LP的存在（预后价值）及闪烁显像灌注缺损的位置（诊断价值）。
