Izumida N, Kiyohara K, Asano Y, Tsuchiya S, Hosaki J, Kawano S, Sawanobori T, Hiraoka M
Department of Pediatrics, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Jpn Circ J. 1993 Feb;57(2):123-30. doi: 10.1253/jcj.57.123.
Electrocardiographic criteria for right ventricular (RV) hypertrophy in infants generally exhibit low sensitivity in terms of diagnostic accuracy. We studied the QRST isointegral map (QRST-Imap) of body surface potential distribution for the diagnosis of RV overload in patients less than 2 years old. Patients with atrial septal defect (ASD), pulmonary stenosis (PS) and tetralogy of Fallot (TOF) were examined (RV overload group) and the findings of their QRST-Imaps were compared to those of age-matched healthy infants (NOR). QRST-Imaps in RV overload showed abnormal findings, with two maxima or a rightward shift of the maximum with increased amplitude, in contrast to one maximum at the left anterior chest with a single dipole pattern in the NOR group. ASD patients had two maxima with a decreased integral value between them. In PS, two maxima were also observed, with increased integral values of the right maximum as the RV systolic pressure was elevated. TOF patients showed a single maximum shifted to the anterior median line with increased amplitude. These results indicate that the findings of QRST-Imaps are of value in detecting the presence and pattern of RV overload in infants.
婴儿右心室（RV）肥大的心电图标准在诊断准确性方面通常表现出较低的敏感性。我们研究了体表电位分布的QRST等积分图（QRST-Imap）用于诊断2岁以下患者的RV负荷过重情况。对患有房间隔缺损（ASD）、肺动脉狭窄（PS）和法洛四联症（TOF）的患者进行了检查（RV负荷过重组），并将他们的QRST-Imap结果与年龄匹配的健康婴儿（NOR组）进行了比较。RV负荷过重组的QRST-Imap显示出异常结果，有两个最大值或最大值向右移位且幅度增加，相比之下，NOR组在左前胸有一个最大值且呈单偶极模式。ASD患者有两个最大值，两者之间的积分值降低。在PS中，也观察到两个最大值，随着RV收缩压升高，右侧最大值的积分值增加。TOF患者显示一个最大值向前中线移位且幅度增加。这些结果表明，QRST-Imap的结果对于检测婴儿RV负荷过重的存在和模式具有价值。
