Lee K W, Okin P M, Kligfield P, Stein K M, Lerman B B
Department of Medicine, The New York Hospital-Cornell Medical Center, New York, NY 10021, USA.
Am Heart J. 1997 Dec;134(6):1005-13. doi: 10.1016/s0002-8703(97)70019-x.
We compared the performance of precordial QT dispersion, late potentials on the signal-averaged electrocardiogram (ECG), and reduced left ventricular ejection fraction for identification of inducible ventricular tachycardia (VT) in 162 patients undergoing electrophysiologic study (EPS). QT(apex) dispersion in 56 patients with inducible VT (72 +/- 55 msec) was greater than that in 106 patients without inducible VT (55 +/- 36 msec, p < 0.01); dispersion was greater in both groups than in 144 normal subjects (33 +/- 19 msec). A QT(apex) dispersion partition of more than 68 msec, the upper ninety-fifth percentile in normal subjects, identified inducible VT with a specificity of 75% and a sensitivity of 45%. Although the performances of late potentials (specificity 82%, sensitivity 59%) and reduced ejection fraction (specificity 86%, sensitivity 54%) were each stronger than QT dispersion alone for identification of inducible VT, abnormal QT(apex) dispersion remained a significant additional predictor of inducible VT in a logistic regression model that included the three variables (specificity 78%, sensitivity 75%).
我们比较了心前区QT离散度、信号平均心电图(ECG)上的晚电位以及左心室射血分数降低在162例接受电生理检查(EPS)患者中识别可诱发室性心动过速(VT)的性能。56例可诱发VT患者的QT(峰)离散度(72±55毫秒)大于106例不可诱发VT患者(55±36毫秒,p<0.01);两组的离散度均大于144名正常受试者(33±19毫秒)。以正常受试者的第95百分位数以上即QT(峰)离散度超过68毫秒来识别可诱发VT,其特异性为75%,敏感性为45%。虽然晚电位(特异性82%,敏感性59%)和射血分数降低(特异性86%,敏感性54%)在识别可诱发VT方面的性能均比单独的QT离散度更强,但在包含这三个变量的逻辑回归模型中,异常QT(峰)离散度仍是可诱发VT的一个重要额外预测指标(特异性78%,敏感性75%)。