病毒性心肌炎患儿动态心电图结果与心功能改变的关系

目的 探讨病毒性心肌炎患儿动态心电图结果与心功能改变的关系。方法 选取温州市中西医结合医院、温州市妇女儿童医院和温州医科大学附属儿童医院2015年3月至2019年4月收治的186例病毒性心肌炎患儿为研究对象,在治疗前均接受常规心电图、动态心电图和超声心动图检查。比较动态心电图与常规心电图检测结果,比较动态心电图检出与未检出心律失常患儿的心功能指标,分析病毒性心肌炎患儿发生心功能指标改变的影响因素。结果 动态心电图检查显示ST段改变、阵发性室上性心动过速检出率均明显高于常规心电图（均P<0.05）,且心律失常检出率亦明显高于常规心电图（P<0.05）。动态心电图检出心律失常患儿心脏指数、左心室射血分数均明显低于未检出心律失常患儿（均P<0.05）,心脏增大比例明显高于未检出心律失常患儿（P<0.05）。186例病毒性心肌炎患儿心功能指标改变发生率为20.43%。病程>1周（OR=4.341）、动态心电图检出心律失常（OR=7.207）是病毒性心肌炎患儿发生心功能指标改变的独立危险因素（均P<0.05）。结论病程>1周、动态心电图检出心律失常的病毒...     

400例小儿过敏性紫癜的心电图表现与临床分析

目的探讨过敏性紫癜急性期对儿童心电图的影响及心肌损害的原因。方法对400例儿童过敏性紫癜患儿临床心电图资料进行回顾性分析。结果400例过敏性紫癜患儿,心电图正常225例(56.25%),心电图异常175例(43.75%),其中一项异常150例(85.71%),两项异常25例(14.29%)。主要以Q-T延长、窦性心动过缓、ST-T改变为主。结论过敏性紫癜急性期有不同程度的心脏损害及心电图异常表现。     

兰州地区1100例中老年人体检心电图分析

目的分析中老年人群体检者中心电图异常发生情况。方法 1100例中老年体检者在安静状态下平卧,采用日本光电十二导心电图记录仪,采集心电图。结果 1100例中老年人群中正常心电图632例（57.45%）,大致正常心电图220例（20.00%）;异常心电图248例（22.54%）,其中心律失常62例（5.63%）,ST-T改变89例（8.09%）,传导阻滞87例（7.63%）,心室肥厚10例（0.90%）。传导阻滞主要发生于≥66岁组,以66～70岁组为最高;ST-T改变中≥66岁各组发生率基本相同。结论中老年干部人群中,异常心电图的发生率较高,并以传导阻滞和ST-T改变为主要类型,提示应加强对中老年人群中心血管疾病的预防。     

手足口病患儿心肌酶检测及心电图分析

目的探讨手足口病（HFMD）患儿伴发心肌损害所致心肌酶、心电图及cTnI异常表现。方法对180例确诊患儿和我院同期住院的小儿外科患儿100例同时于入院次日和病程结束后,行心肌酶谱、心电图和cTnI检查。结果①HFMD患儿与正常小儿比较心肌酶谱明显升高（P〈0.01）;②HFMD患儿心电图异常率71.3%,以ST-T改变为主;③HFMD患儿cTnI异常44例（占24.4%）;④心肌酶谱、cTnI、心电图三者具有相关性。结论部分HFMD患儿伴发心肌损害时心肌酶谱和cTnI明显升高,心电图出现异常改变。早期进行心肌酶学、cTnI和心电图等检测,有助于HFMD患儿心肌损害的早期诊断和治疗。     

100例颅脑外伤引发心电图改变的临床分析

目的对颅脑外伤患者的心电图改变进行探讨,分析其临床意义。方法回顾性分析2007年7月～2009年7月100例颅脑外伤患者入院后的心电图变化,进行分组对比。结果 100例中有48例重度颅脑外伤,其中27例？56%？并发心电图异常;52例轻度颅脑外伤,其中10例（19%）并发心电图异常。重度颅脑外伤组出现异常心电图的例数明显多于轻度颅脑外伤组（P〈0.05）;心电图异常组出现死亡或病情恶化的例数明显多于心电图正常组（P〈0.05）。19例恶化或死亡病例中11例（57%）显示心电图异常。结论颅脑外伤者的心电图异常,提示病情较重,预后较差。     

甲状腺机能亢进患者的心电图分析

目的探讨甲状腺机能亢进（甲亢）患者的心电图表现。方法对85例甲亢患者心电图资料进行分析,85例性别、年龄匹配的健康体检者作为正常对照。结果甲亢患者心电图异常改变76例（89.41%）,正常对照组心电图异常改变为16例（18.82%）,二者差异有统计学意义（p〈0.001）。甲亢患者心电图改变以窦速、ST-T改变、房颤为主。结论甲亢患者心电图异常发生率较高,多表现为窦速、ST-T改变、房颤。     

Duchenne型肌营养不良儿童心电图改变及其临床意义的探讨

研究41例Duchenne型肌营养不良(DMD)儿童和101名正常同龄儿童的心电图,经比较分析,DMD组心电图指标异常24项,分别涉及40例患儿,其中主要改变是V_1导联高R波,Ⅰ、Ⅱ、Ⅲ、aVL、aVF、V_(5-3)导联深窄Q波及ST-T改变、Q-T间期延长和窦性心动过速等。结合患儿的心缩间期测量结果发现,心电图异常越显著,改变项目越多,其心功能下降越明显,提示利用心电图指标可综合估价DMD患儿的心功能状况。     

糖调节受损者心电图异常特点分析

目的调查和分析糖调节受损（IGR）患者临床心电图异常改变的特点,探讨IGR与心血管疾病的关系。方法对经空腹血糖（FPG）和葡萄糖耐量试验（OGTT）确诊的202例IGR患者、200例糖耐量正常（NGT）患者,进行12导联心电图检查。结果 IGR患者组心电图异常者53例（26.24%）,其中主要表现为ST-T改变、左室肥厚劳损、期前收缩、心房纤颤、束支阻滞等,其发生率分别为10.40%、6.43%、4.46%、2.97%、1.98%;明显高于NGT组心电图异常者18例（9.00%）,差异有统计学意义（P〈0.01）。结论 IGR患者心电图异常改变与糖代谢异常有关。     

妊娠晚期孕妇心电图改变临床意义及处理

目的分析妊娠晚期孕妇心电图的改变,探讨其临床意义及处理方法。方法回顾性分析1120例妊娠晚期孕妇常规同步12导联心电图,与正常体检妇女进行比较,分析其临床意义及相应处理。结果观察组：1120例妊娠晚期妇女异常心电图425例,占37.9%,心肌酶异常（任一项超过正常值2倍以上为异常,以下同）者26例,占心电图异常者的6.1%;对照组：正常体检妇女异常心电图83例,占8%,心肌酶异常者6例,占心电图异常者的7.2%。两组异常心电图发生率相比差异有显著意义。对照组心肌酶异常发生率虽有增加,但差异无显著性。结论妊娠晚期心电图改变大部分为生理性变化,无症状者无须特殊处理,给予休息、吸氧,可以纠正,对有症状且心肌酶谱异常者需积极寻找病因给予及时、适当的对症对因治疗,确保母婴安全。     

中老年糖调节受损患者临床心电图异常特点分析

目的探讨中老年糖调节受损（IGR）患者临床心电图异常与心血管危险因素的关系。方法对经OGTT确诊的260例（IGR）患者、111例糖耐量正常（NGT）者,进行血压、血脂、BMI和标准的12导联心电图检查。结果（1）IGR患者组心电图异常、ST-T改变、左室肥厚劳损、期前收缩、心房颤动、陈旧性心肌梗死、左前分支阻滞发生率分别为36.9%（年龄校正后为33.1%）、18.5%、13.8%、11.2%、8.5%、7.3%、5.0%,明显高于NGT组（9.0%、5.4%、2.7%、2.7%、0.9%、0.9%、1.8%）,差异有统计学意义（P〈0.05～0.01）;（2）IGR组中96例心电图异常者以ST-T改变和左室肥劳损发生率最高（分别为50%和38%）;（3）IGR患者合并高血压和合并血脂异常组左室肥厚劳损和陈旧性心肌梗死心电图发生率明显升高（P〈0.01）;（4）60岁和70岁年龄段组心电图ST-T改变发生率最高。结论心电图异常改变与糖代谢异常有关。     

心电图正常或呈非特异性改变的冠心病患者心磁图分析

目的探讨心磁图(Magnetocardiography,MCG)对于静息心电图表现正常或呈非特异性改变的冠心病患者的诊断价值并筛选实用的诊断指标。方法采用德国Magscan公司生产无屏蔽式MCG-7记录仪,选择平均分级(averageclassificationoftotalmaps,ACTM)、异常心磁图所占百分比(ratioofabnormalmaps,RAM)、复合心室激动指数(complexventricularexcitationindex,CVEI)以及R波与T波的最大磁场值比值(Rmax/Tmax)四个分析指标,比较冠心病组(n=140,冠状动脉造影提示至少一支冠状动脉狭窄≥70%)与对照组(n=82例,冠状动脉造影显示冠状动脉完全正常)的MCG结果。结果冠心病组异常磁图的比例达到62%,多数电流密度图无明显双极对称结构,而对照组异常磁图的比例为35%,电流密度图有明显双极对称结构。冠心病组平均分级(2.62±0.98)显著高于对照组(2.29±0.90)。冠心病组的CVEI值位于异常区域(-100~0)内,而对照组CVEI值位于正常区域内(0~100)。Rmax/Tmax的比值在冠心病组高于对照组(6.41±3.29比4.10±2.00)。上述指标两组间差异均有统计学意义(P≤0.05)。通过受试者工作特征曲线(ROC曲线)分析表明,RAM、CVEI及Rmax/Tmax的诊断价值相对较高,敏感性分别为67.1%,65.9%及64.3%。特异性分别为65.1%,68.3%及68.3%。结论MCG对于静息心电图表现正常或呈非特异性改变者的慢性心肌缺血患者有独特的诊断价值,有利于冠心病的早期诊断。     

子宫肌瘤患者的心电图分析

目的探讨子宫肌瘤患者的心电图表现。方法对200例子宫肌瘤患者心电图资料进行分析,200例健康体检女性作为对照组。结果子宫肌瘤患者心电图异常改变133例(66.5%),正常对照组心电图异常改变为46例(23%),二者差异有统计学意义。子宫肌瘤患者心电图异常以ST-T变化为主。结论子宫肌瘤患者心电图异常发生率较高,多表现为ST-T异常改变。     

Life expectancy analysis in patients with Chagas' disease: prognosis after one decade (1973-1983)

We studied the evolution of chronic Chagas' disease in 107 patients with a positive Guerreiro-Machado reaction and 22 non-chagasic, non-heart disease control subjects for a follow-up period of 3 to 10 years (mean follow-up of 4.9 years). After completion of invasive and non-invasive studies, chagasic patients were classified into four groups: IA (normal ECG, without heart disease; 18 patients); IB (normal ECG, early left ventricular segmental abnormalities; 13 patients); II (abnormal ECG, advanced myocardial damage, no signs of heart failure; 42 patients); and III (abnormal ECG, end-stage, congestive heart failure; 34 patients). One out of five group IA patients re-studied with invasive methods evolved to group IB (20%); 4 group IB patients evolved to group II (33%) and 6 group II patients evolved to group III (15%). The life expectancy of patients in groups IA and IB (normal ECG) was similar to that of our control group, whereas in groups II and III it was significantly decreased (P less than 0.001). Nine group II patients (23%) and 28 group III patients (82%) died during the follow-up period. Main terminal events were refractory congestive heart failure, sudden death and systemic thromboembolism. Our findings suggest that chronic Chagas' disease follows an evolutionary course from asymptomatic, normal ECG group I stage to arrhythmic (II) and congestive (III) stages. Subjects with a positive Guerreiro-Machado reaction showed a significantly lower life expectancy than our control group, but only when clinical and/or ECG abnormalities were identified.     

中青年甲亢患者心电图分析

目的 探讨心电图变化对中青年甲亢的诊断价值。方法 对我院门诊就诊且初次诊断为甲亢的75例患者的心电图资料进行分析,并且选择75例来我院体检,性别、年龄匹配的正常人群的心电图资料作为对照。结果 甲亢组患者心电图改变37例(49.33%),正常对照组心电图改变23例(30.67%),两组差异有统计学意义(P<0.05),且心电图改变主要为ST段、T波的改变。甲亢组心率明显快于正常对照组,甲亢组心率(77.72±12.98)次/min,正常对照组心率(71.29±10.14)次/min,两组差异有统计学意义。甲亢患者中,心电图异常率女性患者(61.70%)明显高于男性患者(32.14%),两者比较差异有统计学意义。甲亢组相对于对照组QT间期缩短、QTc间期延长、P波振幅增高,两组比较差异有统计学意义。结论 甲亢患者心电图异常发生率比对照组高,心电图对甲亢的诊断有一定的参考价值。     

右束支传导阻滞T环形态及异常的临床价值探讨

目的 :探讨心电向量图对右束支传导阻滞 (RBBB)的T环形态及异常的临床价值。方法 :对心电图无RBBB的心肌梗死 (MI)患者 (MI组 )、正常人 (对照组 )各 5 0例及心电图RBBB者 (RBBB组 ,6 6例 )进行心电向量图检查 ,分析T向量环形态及临床意义。结果 :对照组T环形态多呈狭长型 ,占 96 % (4 8/ 5 0 ) ;MI组T环多呈圆小型、狭小型和圆长型 ,占 94 % (4 7/ 5 0 )。两组比较差异有统计学意义 (P <0 .0 1)。RBBB组中正常亚组 (31例 ) ,T环形态呈狭长型占 90 .3% (2 8/ 31) ,异常亚组 (35例 )T环形态呈圆小型、狭小型和圆长型 ,占 71.4 % (2 5 /35 )。两亚组比较差异有统计学意义 (P <0 .0 1)。结论 :心电向量图检查可以揭示RBBB的T环改变 ,对心肌缺血病变的早期诊断具有重要意义     

The prevalence of hypertrophic cardiomyopathy in men: an echocardiographic population screening study with a review of death records.

The purpose of this study was to estimate the prevalence of hypertrophic cardiomyopathy (HCM) in 3607 men from the Reykjavik study of 1979-81. Of these, 452 men had an abnormal (group A) and 3155 a normal electrocardiogram. An echocardiographic control group of 128 men was selected from cohorts with a normal electrocardiogram (group B). Until 1987, 189 deaths had occurred, 59 from group A and 130 from cohorts with a normal ECG including 4 from group B. To identify subjects with HCM, survivors of groups A and B were examined by echocardiography and by review of all autopsy data and death certificates. HCM was found in 14 subjects from group A but none in group B. Two additional cases were found at autopsy in cohorts with a normal ECG. The prevalence of HCM in men with an abnormal and normal ECG was 3.6% and 0.8%, respectively. The overall prevalence was calculated to be 1.1% with a 95% confidence interval of 0.3-3.2%. Men with HCM reported more symptoms than others in groups A and B (P < 0.05-0.001). 25% were without symptoms. Asymptomatic ventricular arrhythmias were detected by Holter monitoring in 45% of men with HCM. The total annual mortality was 1.6% compared with 0.5% in the group with a normal ECG (P < 0.001).     

Cardiac troponin I (CTnI) level among children with epileptic seizures

Epilepsy is a common chronic neurological disorder in pediatric age characterized by recurrent, unprovoked seizures; these seizures are transient signs of abnormal excessive or hyper synchronous neuronal activity in the brain. Complicated epilepsy is associated with high seizure frequency, prolonged seizures and may lead to some sort of cardiac ischemia, myocardial injury and elevated serum CTnI.AimA possible importance of Cardiac troponin I (CTnI) level in epileptic children.Patients and methodsThe study was carried out upon 90 children, classified into three groups: Group I: 30 with uncomplicated epilepsy. Group II: 30 with complicated epilepsy. Group III (control): 30 apparently clinically healthy children with similar age and sex. All groups were subjected to the following: full history taking – thorough clinical examination – EEG – assessment of serum cardiac troponin I- and CT only for groups I and II.ResultsOur research revealed a significant statistical increase in the cardiac troponin level (CTnI) maximum in group II followed by group I then lastly group III and revealed a direct correlation between cardiac troponin I and presence of prenatal problem, mental retardation, EEG abnormality and abnormal C T or MRI. There was an indirect correlation between cardiac troponin I and age of seizure onset. Also there was one between cardiac troponin I and etiology of epilepsy.ConclusionCardiac troponin I is a perfect tool for early detection of cases with myocardial dysfunction in epileptic patients – cardiac troponin I is significantly increased in children with epilepsy especially the complicated epilepsy. Cardiac injury in epileptic children is more common in patients with early onset epilepsy, positive prenatal problem, idiopathic epilepsy, abnormal imaging and EEG – elevated TnI levels may be of value in assessing the severity and eventual outcome and mortality risk of the disease in children with epilepsy.     

Variations in diagnostic yield of head-up tilt test and electrophysiology in groups of patients with syncope of unknown origin.

AIMS: To assess the diagnostic yield of the head-up tilt test and electrophysiology in different groups of patients with syncope of unknown origin established according to simple clinical criteria. METHODS AND RESULTS: Six hundred consecutive patients with syncope of unknown origin submitted to a tilt test. Two hundred and forty seven of them also underwent electrophysiology. Patients were divided into groups according to age at the time of first syncope, ECG findings and the presence of organic heart disease. Positive responses to the tilt test were more common in patients who had suffered their first syncope at an age equal to or below 65 years (group I) than in older patients (group II) (47% vs 33%, P<0.05, OR 1.8, CI 1.2-2.78), and in patients with a normal ECG and without organic heart disease than in the other subgroups of patients (47% vs 37%, P<0.008, OR 1.6). The lowest rate of positive response was observed in older patients with an abnormal ECG and organic heart disease. Electrophysiology disclosed abnormal findings in group II more often than in group I (23% vs 7%, P<0.001, OR 3.7, CI 1.7-9.2). The diagnostic yield from electrophysiology was higher in patients with an abnormal ECG than in those with a normal ECG (22% vs 3.7%, P<0.0005, OR 7.1), and it was especially low in patients with a normal ECG and without organic heart disease (2.6%). CONCLUSION: The diagnostic yield of the tilt test and electrophysiology differs in groups of patients with syncope of unknown origin, established according to simple clinical criteria. These findings have a bearing on selecting the most appropriate test in a particular patient.     

Correlation of Noninvasive Electrocardiography with Invasive Electrophysiology in Syncope of Unknown Origin: Implications from a Large Syncope Database

Background: The evaluation of syncope can be expensive, unfocussed, and unrevealing yet, failure to diagnose an arrhythmic cause of syncope is a major problem. We investigate the utility of noninvasive electrocardiographic evaluation (12‐lead ECG and 24‐hour ambulatory electrocardiographic recordings) to predict electrophysiology study results in patients with undiagnosed syncope. Methods: We evaluated 421 patients with undiagnosed syncope who had an electrocardiogram (ECG), an electrophysiology study, and 24‐hour ambulatory monitoring. Noninvasive testing was used to predict electrophysiology testing outcomes. Multivariable logistic regression analysis adjusting for age, sex, presence of heart disease, and left ventricular ejection fraction (LVEF) was used to assess independent predictors for sinus node disease, atrioventricular node disease, and induction of ventricular tachyarrhythmias. Results: Patients were divided into four groups: group 1, abnormal ECG and ambulatory monitor; group 2, abnormal ECG only; group 3, abnormal ambulatory monitor; and group 4, normal ECG and ambulatory monitor. The likelihood of finding at least one abnormality during electrophysiologic testing among the four groups was highest in group 1 (82.2%) and lower in groups 2 and 3 (68.1% and 33.7%, respectively). In group 4, any electrophysiology study abnormality was low (9.1%). Odds ratios (OR) were 35.9 (P < 0.001), 17.8 (P < 0.001), and 3.5 (P = 0.064) for abnormal findings on electrophysiology study, respectively (first three groups vs the fourth one). ECG and ambulatory monitor results predicted results of electrophysiology testing. Conclusion: Abnormal ECG findings on noninvasive testing are well correlated with potential brady‐ or/and tachyarrhythmic causes of syncope, in electrophysiology study of patients with undiagnosed syncope.