摘要
目的探讨DETERMINE积分对右室流出道起源的室性早搏(right ventricular outflow tract premature ventricular contraction,RVOT-PVC)与致心律失常性右室心肌病(arrhythmogenic right ventricular cardiomyopathy,ARVC)的鉴别价值。方法回顾性分析25例ARVC和59例RVOT-PVC患者,对窦性心律心电图参数及特征进行比较。基于病理性Q波、碎裂QRS波及T波倒置的导联数计算DETERMINE积分。结果窦性心律下ARVC组epsilon波(12.00%vs.0,P<0.01)、V_(1)—V_(3)导联T波倒置(68.00%vs.37.29%,P=0.010)及左束支阻滞型室速(52.00%vs.16.95%,P=0.001)的发生率更高。单一心电图特征对ARVC的鉴别诊断效能较差(敏感性<70.0%)。ARVC组DETERMINE积分显著高于RVOT-PVC组[(5.80±2.56)分vs.(0.58±1.22)分,P<0.01]。以DETERMINE积分>3分为切点值,鉴别ARVC与RVOT-PVC的敏感性和特异性分别为92.0%和91.5%,阳性预测值和阴性预测值分别为82.8%和98.2%。结论简易DETERMINE积分可用于鉴别诊断ARVC与RVOT-PVC,具有一定的临床应用价值。
Objective To investigate the value of DETERMINE score in differentiating right ventricular outflow tract premature ventricular contraction(RVOT-PVC)and arrhythmogenic right ventricular cardiomyopathy(ARVC).Methods Twenty-five patients with ARVC and 59 patients with RVOT-PVC were retrospectively analyzed.Their ECG parameters and characteristics of sinus rhythm were compared.DETERMINE score was calculated based on the number of leads with pathological Q waves,fragmented QRS complex,and T wave inversion.Results ARVC group in sinus rhythm has higher incidences of epsilon waves(12.00%vs.0,P<0.01),T wave inversion in leads V_(1)-V_(3)(68.00%vs.37.29%,P=0.010)and ventricular tachycardia with left bundle branch block mor-phology(52.00%vs.16.95%,P=0.001).The single ECG characteristic above is poor in identifying ARVC(sensitivity<70.0%).The DETERMINE score in the ARVC group is significantly higher than that in the RVOT-PVC group[(5.80±2.56)vs.(0.58±1.22),P<0.01].The sensitivity and specificity of higher DETERMINE score(>3)are separately 92.0%and 91.5%while positive and negative predictive values are 82.8%and 98.2%,respectively.Conclusion Simple DETERMINE score can be utilized to differentiate ARVC from RVOT-PVC.The score system has certain clinical application value.
作者
王俊
徐宗政
李庆祝
汪祥海
王德国
WANG Jun;XU Zongzheng;LI Qingzhu;WANG Xianghai;WANG Deguo(Department of Geriatric Medicine,the First Affiliated Hospital of Wannan Medical College,Wu-hu Anhui 241001,China;Department of Medical Imaging,the First Affiliated Hospital of Wannan Medical College,Wu-hu Anhui 241001,China;Department of Cardiovascular Medicine,the First Affiliated Hospital of Wannan Medical College,Wu-hu Anhui 241001,China)
出处
《实用心电学杂志》
2022年第5期336-340,共5页
Journal of Practical Electrocardiology
基金
安徽省科技厅重点研究与开发项目(2022e07020019)。
关键词
DETERMINE积分
致心律失常性右室心肌病
心电图
右室流出道起源的室性早搏
DETERMINE score
arrhythmogenic right ventricular cardiomyopathy
electrocardiogram
right ventricular outflow tract premature ventricular contraction
