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首页> 外文期刊>The American Journal of Cardiology >Comparison of diagnostic and prognostic value of different electrocardiographic criteria to delayed-enhancement magnetic resonance imaging for healed myocardial infarction.
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Comparison of diagnostic and prognostic value of different electrocardiographic criteria to delayed-enhancement magnetic resonance imaging for healed myocardial infarction.

机译：比较不同心电图标准对延迟增强磁共振成像对治愈的心肌梗塞的诊断和预后价值。

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摘要

The accuracy of various electrocardiographic (ECG) criteria for the diagnosis of healed myocardial infarction (MI) has never been validated. The objective of this study was to determine the accuracy and prognostic value of standard ECG criteria for the diagnosis of healed MI compared with cardiac magnetic resonance (CMR). Consecutive patients with known or suspected coronary artery disease who were referred for CMR were studied. Twelve-lead electrocardiography and CMR were performed the same day. A standard CMR protocol including a delayed-enhancement (DE) technique was performed. The prognostic value of using various ECG criteria and DE-CMR was assessed for the occurrence of cardiac death, nonfatal MI, or major adverse cardiac events. We studied 1,366 patients. Average follow-up was 31.4 +/- 15.8 months. Myocardial scar was detected in 507 patients (37.1%) using DE-CMR. Healed MI using various ECG criteria had sensitivity, specificity, and accuracy of 44% to 59%, 91% to 95%, and 75% to 79% compared with DE-CMR, respectively. Multivariable Cox regression analysis showed that myocardial scar using DE-CMR was the most powerful predictor for cardiac events, followed by left ventricular ejection fraction. In the absence of DE-CMR data, MI using European Society of Cardiology/American College of Cardiology (ESC/ACC) 2000 criteria was the most powerful predictor. In conclusion, various ECG criteria had limited sensitivity, but high specificity, for the diagnosis of healed MI compared with myocardial scar using DE-CMR. Myocardial scar, left ventricular ejection fraction, and MI using ESC/ACC 2000 criteria were important predictors for cardiac events.
机译：从未验证过各种用于诊断心肌梗死（MI）的心电图（ECG）标准的准确性。这项研究的目的是确定标准ECG标准与心脏磁共振（CMR）相比对诊断MI的准确性和预后价值。研究了接受CMR治疗的已知或疑似冠状动脉疾病的连续患者。当天进行十二导联心电图和CMR。执行了包括延迟增强（DE）技术的标准CMR协议。评估使用各种ECG标准和DE-CMR对心脏死亡，非致命性MI或主要不良心脏事件的发生的预后价值。我们研究了1,366名患者。平均随访时间为31.4 +/- 15.8个月。使用DE-CMR检测出507例患者的心肌瘢痕（占37.1％）。与DE-CMR相比，使用各种ECG标准治愈的MI的敏感性，特异性和准确性分别为44％至59％，91％至95％和75％至79％。多变量Cox回归分析表明，使用DE-CMR的心肌瘢痕是心脏事件的最有力预测指标，其次是左心室射血分数。在缺乏DE-CMR数据的情况下，使用欧洲心脏病学会/美国心脏病学会（ESC / ACC）2000年标准的MI是最有力的预测指标。总之，与使用DE-CMR进行的心肌瘢痕诊断相比，各种ECG标准诊断心肌梗死的敏感性有限，但特异性较高。使用ESC / ACC 2000标准，心肌疤痕，左心室射血分数和MI是心脏事件的重要预测指标。

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