The spatial QRS-T angle as a marker of ventricular repolarisation in hypertension
作者:P Dilaveris、E Gialafos、A Pantazis、A Synetos、F Triposkiadis、J Gialafos
DOI:10.1038/sj.jhh.1001129
日期:2001.1.1
Ventricular repolarisation abnormalities are important in arrhythmia provocation. The dispersion of repolarisation duration is not the only aspect of repolarisation heterogeneity. Spatial vectorcardiographic descriptors constitute a novel approach to quantify ventricular repolarisation. To test the ability of vectorcardiographic descriptors to discriminate between hypertensives with high or low blood pressure (BP), 110 treated hypertensives (mean age 63.6 ± 12.1 years) were classified in the high (systolic BP ⩾160 mmâHg or diastolic BP ⩾95 mmâHg) (n = 67), or the low (systolic BP < 160 mmâhg and diastolic bp <95 mmâhg) (n = 43) BP group. The maximum QT, JT, and T peakâT end intervals and the QT, JT, and T peakâT end dispersion were calculated from a digitally recorded 12-lead electrocardiogram (ECG). X, Y, and Z leads were reconstructed from the 12-lead ECG. The amplitude of the maximum spatial T vector (spatial T amplitude), the angle between the maximum spatial QRS and T vectors (spatial QRS-T angle) and the frontal plane QRS-T angle were calculated. The spatial QRS-T angle was higher in patients with high compared to those with low BP (P = 0.025). All conventional ECG markers of the dispersion of ventricular repolarisation duration failed to demonstrate significant differences between hypertensives with high or low BP. In conclusion, the spatial QRS-T angle was significantly increased in those treated hypertensive patients who showed repeatedly high BP values. Hence, we may suggest that the angle between the directions of ventricular depolarisation and repolarisation is a sensitive marker of the repolarisation alterations in systemic hypertension.
心室复极异常在心律失常诱发中具有重要意义。复极持续时间的分散不是复极异质性的唯一方面。空间矢量心电图描述符构成了一种量化心室复极的新方法。为了测试矢量心电图描述符区分高血压和低血压患者的能力,对110名接受治疗的高血压患者(平均年龄63.6 ± 12.1岁)进行了分类,高血压组(收缩压≥160 mmHg或舒张压≥95 mmHg)(n = 67)和低血压组(收缩压<160 mmHg且舒张压<95 mmHg)(n = 43)。从数字化记录的12导联心电图(ECG)中计算最大QT、JT和T峰-T末间期,以及QT、JT和T峰-T末的分散。X、Y和Z导联是从12导联ECG重构而来。计算最大空间T矢量的振幅(空间T振幅)、最大空间QRS和T矢量之间的角度(空间QRS-T角度)以及前额面QRS-T角度。与低血压患者相比,高血压患者的空间QRS-T角度显著更高(P = 0.025)。所有常规心电图标志的心室复极持续时间分散在高血压和低血压患者之间未显示显著差异。总之,在那些反复出现高血压值的接受治疗的高血压患者中,空间QRS-T角度显著增加。因此,我们可以建议心室去极化和复极化方向之间的角度是系统性高血压复极变化的敏感标志。