信号平均心电图新的性别相关正常范围。

New sex dependent normal limits of the signal averaged electrocardiogram.

作者信息

Yang T F, Macfarlane P W

机构信息

Department of Medical Cardiology, Royal Infirmary, University of Glasgow.

出版信息

Br Heart J. 1994 Aug;72(2):197-200. doi: 10.1136/hrt.72.2.197.

DOI:10.1136/hrt.72.2.197

PMID:7917698

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1025489/

Abstract

BACKGROUND

An earlier study of 1555 normal 12 lead electrocardiograms has shown that the mean QRS duration in men is 8 ms longer than in women.

OBJECTIVE

To establish the sex related normal limits of the signal averaged electrocardiogram. PEOPLE: 195 people (160 men and 35 women aged 40 to 69) with normal clinical history, physical examination, 12 lead electrocardiogram, and echocardiogram were recruited for this study.

METHODS

Signal averaged electrocardiograms were recorded by the Arrhythmia Research Technology 1200 EPX machine and analysed twice with bidirectional Butterworth filters with frequency ranges of 25-250 Hz and 40-250 Hz. Three time domain parameters of the QRS vector magnitude, namely filtered total QRS duration, duration of low amplitude signals under 40 microV (LAS40), and root mean square voltage of the last 40 ms (RMS40), were evaluated.

RESULTS

There were significant differences between the two sexes in QRS duration (mean (95% confidence interval (95% CI) (8.0 (3.1 to 13.0) ms, t = 3.29, degrees of freedom = 41, p = 0.0021 with the 25-250Hz filter; mean (95% CI) 10.2 (6.9 to 13.5) ms, t = 6.26, degrees of freedom = 53, p < 0.0001 with the 40-250Hz filter)) and in body surface area (mean (95% CI) 0.26 (0.21 to 0.31) m2, t = 10.63, degrees of freedom = 57). There was no significant correlation between age and QRS duration, LAS40, or RMS40, but there was a highly significant correlation between body surface area and QRS duration (correlation coefficient = 0.396, p < 0.0005) and RMS40 (correlation coefficient = -0.159, p < 0.025). Current sex independent criteria defining ventricular late potentials as the presence of any two of QRS duration > 114 ms, LAS40 > 38 ms, RMS40 < 20 microV, give a specificity of 85% for men and 91% for women in this normal population.

RECOMMENDATIONS

Ventricular late potentials should be regarded as present when (a) QRS duration exceeds 114 ms in men or 104 ms in women and (b) either LAS40 > 38 ms or RMS40 < 20 microV. This gives a specificity of 97% in men and 100% in women in the population studied.

摘要

背景

一项对1555份正常12导联心电图的早期研究表明，男性的平均QRS时限比女性长8毫秒。

目的

确定信号平均心电图与性别相关的正常范围。

研究对象

招募了195名（160名男性和35名年龄在40至69岁之间的女性）临床病史、体格检查、12导联心电图和超声心动图均正常的人员参与本研究。

方法

使用心律失常研究技术公司的1200 EPX机器记录信号平均心电图，并使用频率范围为25 - 250赫兹和40 - 250赫兹的双向巴特沃斯滤波器进行两次分析。评估QRS向量幅度的三个时域参数，即滤波后的总QRS时限、40微伏以下低幅度信号的持续时间（LAS40）以及最后40毫秒的均方根电压（RMS40）。

结果

两性在QRS时限（使用25 - 250赫兹滤波器时，均值（95%置信区间）（8.0（3.1至13.0）毫秒，t = 3.29，自由度 = 41，p = 0.0021；使用40 - 250赫兹滤波器时，均值（95%置信区间）10.2（6.9至13.5）毫秒，t = 6.26，自由度 = 53，p < 0.0001）和体表面积（均值（95%置信区间）0.26（0.21至0.31）平方米，t = 10.63，自由度 = 57）方面存在显著差异。年龄与QRS时限、LAS40或RMS40之间无显著相关性，但体表面积与QRS时限（相关系数 = 0.396，p < 0.0005）和RMS40（相关系数 = -0.159，p < 0.025）之间存在高度显著相关性。目前将心室晚电位定义为存在QRS时限>114毫秒、LAS40>38毫秒、RMS40<20微伏中的任意两项的性别独立标准，在该正常人群中，男性的特异性为85%，女性为91%。