高频QRS波运动心电图对心肌缺血多点诊断优势及应用前景

摘要/Abstract

摘要： 全球心血管疾病致死率居疾病死亡首位。其中,中国人群心血管疾病的病死率最高,冠心病是我国心血管疾病发病率排名第二的疾病。而运动平板作为冠心病筛查的主要检查方式,敏感性及特异性相对较差。高频QRS分析是一种补充运动平板ST段评估的心电诊断工具,通过分析QRS波群中心部分存在的高频成分,为常规心电图诊断提供附加信息,以更敏感、精准地捕捉心肌缺血的状态,为实现心梗早预警、早防患、早干预治疗提供了可能。现就高频QRS波运动心电图对心肌缺血多点诊断优势及应用前景做一综述。

关键词: 高频QRS分析, 心肌缺血, 冠心病, 研究进展

彭珽, 吴秀勤, 缪汝佳, 王建刚. 高频QRS波运动心电图对心肌缺血多点诊断优势及应用前景[J]. 心血管病防治知识, 2022, 12(21): 91-94.

参考文献 27

[1]	Mensah G A, Roth G A, Fuster V.The Global Burden of Cardiovascular Diseases and Risk Factors: 2020 and Beyond[J]. J Am Coll Cardiol, 2019,74(20):2529-2532.
[2]	《中国心血管健康与疾病报告2020》概述[J]. 中国心血管病研究, 2021,19(07):582-590.
[3]	中国心血管健康与疾病报告2019[J].心肺血管病杂志, 2020,39(10):1157-1162.
[4]	Park K E, Richard C C.Prognostic Significance of Asymptomatic Myocardial Ischemia in Women vs. Men[J]. Curr Pharm Des, 2016,22(25):3871-3876.
[5]	刘忠明,余海波,杨俊.高频心电图联合MRI在隐匿性冠心病诊断中的价值及影像特点观察[J]. 中国CT和MRI杂志, 2019,17(9):87-90.
[6]	Kohli P, Gulati M.Exercise stress testing in women: going back to the basics[J]. Circulation, 2010,122(24):2570-2580.
[7]	陈文彬等. 诊断学[M]. 北京:人民卫生出版社, 2008.
[8]	Omer N, Bergman E, Ben-David T, et al.Changes in High-Frequency Intracardiac Electrogram Indicate Cardiac Ischemia[J]. J Cardiovasc Transl Res, 2021.
[9]	Douglas P S, Hoffmann U, Patel M R, et al.Outcomes of anatomical versus functional testing for coronary artery disease[J]. N Engl J Med, 2015,372(14):1291-1300.
[10]	Detrano R, Gianrossi R, Mulvihill D, et al.Exercise-induced ST segment depression in the diagnosis of multivessel coronary disease: a meta analysis[J]. J Am Coll Cardiol, 1989,14(6):1501-1508.
[11]	Thomas GS, Wann LS, Ellestad M.Ellestad's stress testing:principles and practice. 6th ed. New York: Oxford University Press, 2018.
[12]	Duvall W L, Rai M, Ahlberg A W, et al.A multi-center assessment of the temporal trends in myocardial perfusion imaging[J]. J Nucl Cardiol,2015,22(3):539-551.
[13]	Langner P J.The value of high fidelity electrocardiography using the cathode ray oscillograph and an expanded time scale[J]. Circulation, 1952,5(2):249-256.
[14]	Langner P J, DeMott T, Hussey M. High-fidelity electrocardiography: effects of induced localized myocardial injury in the dog[J]. Am Heart J, 1966,71(6):790-796.
[15]	Langer P H Jr, Geselowitz D B, Mansure F T, et al. High-frequency components in the electrocardiograms of normal subjects and of patients with coronary heart disease[J]. Am Heart J, 1961,62:746-755.
[16]	Reynolds E J, Muller B F, Anderson G J, et al.High-frequency components in the electrocardiogram. A comparative study of normals and patients with myocardial disease[J]. Circulation, 1967,35(1):195-206.
[17]	Goldberger A L, Bhargava V, Froelicher V, et al.Effect of myocardial infarction on high-frequency QRS potentials[J]. Circulation, 1981,64(1):34-42.
[18]	Lipton J A, Warren S G, Broce M, et al.High-frequency QRS electrocardiogram analysis during exercise stress testing for detecting ischemia[J]. Int J Cardiol, 2008,124(2):198-203.
[19]	Toledo E, Lipton J A, Warren S G, et al.Detection of stress-induced myocardial ischemia from the depolarization phase of the cardiac cycle--a preliminary study[J]. J Electrocardiol, 2009,42(3):240-247.
[20]	Abboud S, Zlochiver S.High-frequency QRS electrocardiogram for diagnosing and monitoring ischemic heart disease[J].J Electrocardiol, 2006,39(1):82-86.
[21]	Amit G, Granot Y, Abboud S.Quantifying QRS changes during myocardial ischemia: Insights from high frequency electrocardiography[J]. J Electrocardiol, 2014,47(4):505-511.
[22]	葛霁光, 徐雨维, 戴寄望, 心脏病与高频心电研究[J]. 浙江大学学报(自然科学版), 1991(06):22-29.
[23]	Schaerli N, Abacherli R, Walter J, et al.Incremental value of high-frequency QRS analysis for diagnosis and prognosis in suspected exercise-induced myocardial ischaemia[J]. Eur Heart J Acute Cardiovasc Care, 2020,9(8):836-847.
[24]	Balfour P J, Gonzalez J A, Shaw P W, et al.High-frequency QRS analysis to supplement ST evaluation in exercise stress electrocardiography: Incremental diagnostic accuracy and net reclassification[J]. J Nucl Cardiol, 2020,27(6):2063-2075.
[25]	Galante O, Amit G, Granot Y, et al.High-frequency QRS analysis in the evaluation of chest pain in the emergency department[J]. J Electrocardiol, 2017,50(4):457-465.
[26]	Tragardh E, Pahlm O, Heden B, et al.Serial changes in the high-frequency ECG during the first year following acute myocardial infarction[J]. Clin Physiol Funct Imaging, 2006,26(5):296-300.
[27]	Matsushita S, Sakakibara Y, Imazuru T, et al.High-frequency QRS potentials as a marker of myocardial dysfunction after cardiac surgery[J]. Ann Thorac Surg, 2004,77(4):1293-1297.

高频QRS波运动心电图对心肌缺血多点诊断优势及应用前景

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 27

相关文章 15

编辑推荐

Metrics

本文评价

[1]	冯青, 李启仁, 陈鸿仪, 刘文龙, 李伟, 贺生菊. 心肺运动指导冠心病患者运动康复治疗的远期效果评价[J]. 心血管病防治知识, 2023, 13(9): 3-5.
[2]	赵烁, 钟菊芳. 经桡动脉冠状动脉造影术后手肿胀疼痛的影响因素分析[J]. 心血管病防治知识, 2023, 13(9): 6-8.
[3]	陈凤兰, 林宝莲. 华佗再造丸辅助治疗急性缺血性脑卒中并冠心病对血管内皮功能及血脂水平的影响[J]. 心血管病防治知识, 2023, 13(9): 19-21.
[4]	杨燕, 罗琳莹. 子宫肌瘤贫血合并稳定性冠心病患者围术期整合照护理念护理方案的制定与应用研究[J]. 心血管病防治知识, 2023, 13(9): 68-70.
[5]	黄小娇. 护理干预措施应用于冠心病服用肠溶阿司匹林致上消化道出血患者的临床效果观察[J]. 心血管病防治知识, 2023, 13(9): 75-77.
[6]	蔡妍, 陈尔东. 基于协同模式的路径化护理对老年冠心病患者自我管理行为的影响[J]. 心血管病防治知识, 2023, 13(9): 84-86.
[7]	陈文雅, 许景云, 刘建萍. 重症冠心病患者中应用人文关怀护理的效果评价[J]. 心血管病防治知识, 2023, 13(9): 90-92.
[8]	陈君. 基于慢性疾病轨迹模式的护理对老年心绞痛患者的影响[J]. 心血管病防治知识, 2023, 13(9): 93-96.
[9]	罗玉梅. 芪红汤联合芪参益气滴丸治疗冠心病慢性心力衰竭的疗效观察[J]. 心血管病防治知识, 2023, 13(8): 19-21.
[10]	陈雅惠, 朱凯凤, 洪志评, 邓婷. Peplau人际关系理论结合康复护理在冠心病患者中的应用价值[J]. 心血管病防治知识, 2023, 13(8): 43-45.
[11]	蔡丽玲, 林敏. 胃癌合并冠心病患者应用基于健康信念模式的护理干预的效果[J]. 心血管病防治知识, 2023, 13(8): 63-65.
[12]	罗丽芬. 老年冠心病患者延续性健康管理需求及影响因素分析[J]. 心血管病防治知识, 2023, 13(7): 50-52.
[13]	李思念. 老年冠心病患者经皮冠状动脉介入治疗术后健康信念护理的效果及对再入院率的影响[J]. 心血管病防治知识, 2023, 13(7): 88-90.
[14]	袁洁. 协同合作下的延续性护理对老年冠心病患者认知程度及生活质量的影响[J]. 心血管病防治知识, 2023, 13(7): 91-93.
[15]	陈梦凌. 呼吸生物反馈干预对冠心病患者心功能及睡眠质量的影响[J]. 心血管病防治知识, 2023, 13(7): 94-96.