Banasiak W, Pajak I, Ponikowski P, Wiech K, Lacheta W, Telichowski C
Klinika Chorób Wewnetrznych Wojskowego Szpitala Klinicznego we Wrocławiu.
Pol Merkur Lekarski. 1998 Jun;4(24):302-5.
The aim of the study was to assess the time-domain parameters of atrial signal-averaged ECG (ASAECG) and ventricular signal-averaged ECG (SAECG) in patients with mitral valve prolapse (MVP) and healthy ones. Fifty patients with MVP (15 men, 35 women, mean age--37.1 +/- 8.9 years) and 50 healthy controls (36 men, 14 women, mean age 38.2 +/- 4.7 years) were studied). The following time-domain parameters of ASAECG were analysed: the root mean square voltage of the terminal 10, 20, 30 ms of filtered P wave (RMS10, 20, 30) and the total duration of filtered P wave (PWD). The atrial late potentials (ALP) were defined as the presence: RMS10 < 4 microV i PWD > 123 ms. As the time-domain parameters of SAECG we analysed: the root mean square voltage of the terminal 40, 50 ms of the filtered QRS (RMS 40, 50), the total filtered QRS duration (t-QRS) and the low-amplitude signal duration < 40 microV in the terminal QRS (LPD). The ventricular late potentials (VLP) were defined as the presence of at least two of the following criteria: t-QRS > 114 ms, RMS 40 < 20 microV i LPD > 38 ms. There was no difference in the time-domain parameters of ASAECG between patients with MVP and controls: RMS 10: 4.5 +/- 1.8 microV vs 4.8 +/- 1.9 microV, RMS 20: 6.3 +/- 2.2 microV vs 6.1 +/- 2.2 microV, RMS 30: 8.3 +/- 2.5 microV vs 7.1 +/- 2.7 microV and PWD 113 +/- 11.7 ms vs 116 +/- 15.2 ms, respectively. Three patients with MVP (6%) and 5 controls (10%) revealed ALP. THE time-domain parameters of SAECG did not differ in patients with MVP and controls: RMS 40: 40.2 +/- 29.1, microV vs 35.5 +/- 18.2 microV, RMS 50: 68.2 +/- 40.1 microV vs 64.4 +/- 33.6 microV and t-QRS-101.4 +/- 10.7 ms vs 101.8 +/- 10.9 ms i LPD--28.7 +/- 10.0 ms vs 28.3 +/- 10.0 ms, respectively. VLP were found in 7 patients with MVP (14%) and 5 controls (10%). Our findings suggest that time-domain parameters of ASAECG and SAECG could not differentiate patients with MVP and healthy ones. Moreover, the presence of ALP and VLP in MVP group did not correlate with supraventricular and ventricular arrhythmias recorded on ambulatory ECG.
本研究旨在评估二尖瓣脱垂（MVP）患者及健康人群心房信号平均心电图（ASAECG）和心室信号平均心电图（SAECG）的时域参数。研究了50例MVP患者（15例男性，35例女性，平均年龄37.1±8.9岁）和50例健康对照者（36例男性，14例女性，平均年龄38.2±4.7岁）。分析了ASAECG的以下时域参数：滤波后P波终末10、20、30毫秒的均方根电压（RMS10、20、30）以及滤波后P波的总时长（PWD）。心房晚电位（ALP）定义为存在：RMS10<4微伏且PWD>123毫秒。作为SAECG的时域参数，我们分析了：滤波后QRS波终末40、50毫秒的均方根电压（RMS 40、50）、滤波后QRS波的总时长（t-QRS）以及终末QRS波中<40微伏的低振幅信号时长（LPD）。心室晚电位（VLP）定义为至少满足以下两条标准：t-QRS>114毫秒、RMS 40<20微伏且LPD>38毫秒。MVP患者和对照组之间ASAECG的时域参数无差异：RMS 10分别为4.5±1.8微伏和4.8±1.9微伏，RMS 20分别为6.3±2.2微伏和6.1±2.2微伏，RMS 30分别为8.3±2.5微伏和7.1±2.7微伏，PWD分别为113±11.7毫秒和116±15.2毫秒。3例MVP患者（6%）和5例对照者（10%）出现ALP。MVP患者和对照组之间SAECG的时域参数无差异：RMS 40分别为40.2±29.1微伏和35.5±18.2微伏，RMS 50分别为68.2±40.1微伏和64.4±33.6微伏，t-QRS分别为101.4±10.7毫秒和101.8±10.9毫秒，LPD分别为28.7±10.0毫秒和28.3±10.0毫秒。7例MVP患者（14%）和5例对照者（10%）发现有VLP。我们的研究结果表明，ASAECG和SAECG的时域参数无法区分MVP患者和健康人群。此外，MVP组中ALP和VLP的存在与动态心电图记录的室上性和室性心律失常无关。
