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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >New descriptors of homogeneity of the propagation of ventricular repolarization.
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New descriptors of homogeneity of the propagation of ventricular repolarization.

机译：心室复极传播同质性的新描述。

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摘要

Available descriptors of irregularities of ventricular repolarization are of limited clinical value. We studied the effect of autonomic variations on several new descriptors of the three-dimensional T loop. Twelve-lead digital ECGs were recorded continuously in 40 healthy subjects at baseline in the supine position, during postural changes (supine-->sitting-->standing-->supine-->standing), and during Valsalva maneuver performed three times in the supine and three times in the standing positions. A minimum dimensional space was constructed from the 12-lead ECG, using singular value decomposition, on the basis of median ECG beats constructed from 10-second consecutive ECG recordings. Temporal variations (TLA and PL, which measure the T loop area, and LD, the interlead relationship during repolarization) and wavefront direction descriptors (TCRT, the deviation between the QRS and T vectors) were calculated and expressed as normalized values. Values of TLA, PL, and TCRT were significantly lower in the sitting than in the supine position (-38,139 +/- 9099 vs 47,133 +/- 7511, -0.017 +/- 0.005 vs 0.033 +/- 0.005 and -0.032 +/- 0.019 vs 0.071 +/- 0.015, respectively, P < 0.001 for all) and decreased further in the standing position (-88,288 +/- 14,468, -0.067 +/- 0.013, -0.198 +/- 0.025, respectively, P < 0.001 for all). LD increased from supine to sitting (98.7 +/- 29.4 vs -87.5 +/- 15.2, P < 0.001) and increased further, though nonsignificantly in the standing position (118.3 +/- 35.2). TLA, PL, and TCRT decreased from baseline during Valsalva in the supine (-34,118 +/- 11,424 vs 62,234 +/- 12,215, -0.038 +/- 0.014 vs 0.065 +/- 0.010, -0.08 +/- 0.03 vs 0.10 +/- 0.02, respectively, P < 0.001 for all) and standing positions (-108,263 +/- 21,051 vs -68,909 +/- 10,271, -0.109 +/- 0.014 vs -0.048 +/- 0.009, -0.30 +/- 0.035 vs -015 +/- 0.016, respectively, P < 0.05 for all). LD was significantly increased by Valsalva in the supine position (13 +/- 46 vs -153 +/- 30, P < 0.001) and nonsignificantly in the standing position (99 +/- 50 vs 86 +/- 30, P = NS). There were significant correlations among TLA, PL, and LD, and no significant correlation between TCRT and any of the temporal variation descriptors. These new temporal and wavefront direction descriptors are sensitive and rapid detectors of autonomic effects on ventricular repolarization.
机译：心室复极不规则的可用描述符具有有限的临床价值。我们研究了自主变化对三维T环的几个新描述符的影响。在基线状态下（仰卧位->坐姿->站立->仰卧位->站立）以及在Valsalva动作中，在40例健康受试者的仰卧位连续记录十二导联数字心电图。仰卧，站立姿势三遍。基于奇异值分解，基于12导联心电图的最小尺寸空间，是根据连续10秒连续心电图记录构造的中位心电图搏动得出的。计算时间变化（TLA和PL，测量T环面积，LD，复极化期间的导联关系）和波前方向描述符（TCRT，QRS和T向量之间的偏差），并表示为归一化值。坐位时的TLA，PL和TCRT值显着低于仰卧位（-38,139 +/- 9099 vs 47,133 +/- 7511，-0.017 +/- 0.005 vs 0.033 +/- 0.005和-0.032 + / -分别为0.019和0.071 +/- 0.015，所有P均<0.001），并且在站立姿势下进一步下降（分别为-88,288 +/- 14,468，-0.067 +/- 0.013，-0.198 +/- 0.025，P < 0.001）。 LD从仰卧到坐位增加（98.7 +/- 29.4与-87.5 +/- 15.2，P <0.001），并且进一步增加，尽管站立时的姿势无明显变化（118.3 +/- 35.2）。仰卧位Valsalva期间的TLA，PL和TCRT与基线相比有所降低（-34,118 +/- 11,424对62,234 +/- 12,215，-0.038 +/- 0.014对0.065 +/- 0.010，-0.08 +/- 0.03对0.10 + /-0.02，所有P均<0.001）和站立姿势（-108,263 +/- 21,051与-68,909 +/- 10,271，-0.109 +/- 0.014与-0.048 +/- 0.009，-0.30 +/- 0.035相对于-015 +/- 0.016，对于所有对象，P <0.05）。仰卧位Valsalva可使LD显着增加（13 +/- 46 vs -153 +/- 30，P <0.001），而站立姿势则无显着增加（99 +/- 50 vs 86 +/- 30，P = NS ）。 TLA，PL和LD之间存在显着相关，而TCRT与任何时间变化描述符之间都没有显着相关。这些新的时间和波前方向描述符是对心室复极的自主神经作用的灵敏快速检测器。

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