陈旧性心肌梗死患者的微伏级T波电交替

目的研究陈旧性心肌梗死(简称心梗)患者的微伏级T波电交替(MTWA),旨在探讨MTWA的临床意义。方法平板运动试验过程中利用渐量修正技术监测陈旧性心梗患者83例(Ⅰ组,依试验过程中有无室性心律失常发生分为Ⅰa、Ⅰb组),健康人群90例(Ⅱ组)的MTWA,分析各组之间MTWA的差异及MTWA与心梗部位的相关性。结果①各导联组间MTWA除aVR导联三组间无差异外,余导联均有差异;②Ⅰa组与Ⅱ组除aVL导联外余各导联MTWA值无差异(P>0.017);Ⅰa组与Ⅰb组Ⅱ、Ⅲ、aVF导联MTWA值有差异(P<0.017),余各导联MTWA值无差异(P>0.017);Ⅱ组与Ⅰb组各导联MTWA值有差异(P<0.017)。③Ⅰb组不同部位心梗的相关导联MTWA值有差异。结论MTWA可作为陈旧性心梗患者发生恶性室性心律失常危险分层的指标。

Microvolt T wave alternans in postmyocardial infarction patients

Objective To investigate clinical importance of the microvolt T wave alternans(MTWA)in post myocardial infarction(post-MI)patients.Methods MTWA test with modified moving average analysis(MMA)was performed in post-MI patients(n=83)who was comprised of group Ⅰa with non-ventricular arrhythmia during exercise treadmill test and group Ⅰb with ventricular arrhythmia during the test.90 healthy individuals were taken as control(groupⅡ).Difference of MTWA in each group and the relationship between the MTWA value and the infarcted region were analysed.Results ①Value difference of each leads reached statistical significancy in three groups except aVR.②Except aVL,there was no statistical difference in group Ⅰa and Ⅱ on the MTWA value(P>0.017),but it reached statistical significance between Ⅰa and Ⅰb group in Ⅱ,Ⅲ,aVF leads(P<0.017).The difference between Ⅱ group and Ⅰb group in all leads had statistical significance(P<0.017);③In Ⅰb group,different infarction walls showed different MTWA values on correlated ECG.Conclusion MTWA is a promising approach for risk stratification for malignant ventricular arrhythmia in post-MI patients.