超声心动图结合心电图T波振幅对于扩张型心肌病左室收缩功能评估价值研究

邮寄地址:福建省泉州市丰泽区安吉路号中骏裕景湾; 江惠琼; 许德星

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超声心动图结合心电图T波振幅对于扩张型心肌病左室收缩功能评估价值研究

临床研究 | 更新时间：2024-02-04

- 超声心动图结合心电图T波振幅对于扩张型心肌病左室收缩功能评估价值研究
- Evaluation of left ventricular systolic function in dilated cardiomyopathy by echocardiography combined with electrocardiogram T-wave amplitude
- 临床超声医学杂志 2023年25卷第12期
- 作者机构：
  
  1. 福建医科大学附属泉州市第一医院心功能检查室
  2. 福建医科大学附属泉州市第一医院心内科
- 作者简介：
- 基金信息：
  
  福建省卫健委科技计划项目(编号:2021TG025)
- DOI：
  中图分类号：
- 纸质出版日期：2023，
  
  网络出版日期：2024-1-2，
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邮寄地址:福建省泉州市丰泽区安吉路号中骏裕景湾, 江惠琼, 许德星. 超声心动图结合心电图T波振幅对于扩张型心肌病左室收缩功能评估价值研究[J]. 临床超声医学杂志, 2023,25(12).

Evaluation of left ventricular systolic function in dilated cardiomyopathy by echocardiography combined with electrocardiogram T-wave amplitude[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(12).
邮寄地址:福建省泉州市丰泽区安吉路号中骏裕景湾, 江惠琼, 许德星. 超声心动图结合心电图T波振幅对于扩张型心肌病左室收缩功能评估价值研究[J]. 临床超声医学杂志, 2023,25(12). DOI：

Evaluation of left ventricular systolic function in dilated cardiomyopathy by echocardiography combined with electrocardiogram T-wave amplitude[J]. Journal of Clinical Ultrasound in Medicine, 2023,25(12). DOI：

摘要

目的：探讨超声心动图结合心电图T波振幅对于扩张型心肌病（DCM）左室收缩功能的评估价值。方法：选取2018年4月-2022年12月在我院就诊并诊断为DCM的患者80例作为研究对象，根据纽约心脏病学会（NYHA）心功能分级将其分为 NYHA Ⅱ级组（n=28）、NYHA Ⅲ级组（n=26）和NYHA Ⅳ级组（n=26）。所有患者均完善超声心动图和同步12导联体表心电图检查。采用Spearman秩相关分析超声心动图和心电图T波振幅与DCM心功能分级严重程度的相关性。采用ROC曲线分析超声心动图联合心电图T波振幅评估DCM左室收缩功能的诊断效能。结果 NYHA Ⅲ级组和NYHA Ⅳ级组左室收缩期末期容积（LVESV）、左室收缩末期内径（LVESD）、左室舒张末期容积（LVEDV）、左室舒张末期内径（LVEDD）均高于NYHA Ⅱ级组，差异有统计学意义（P＜0.05）；NYHA Ⅳ级组LVESV、LVESD、LVEDV、LVEDD均高于NYHA Ⅱ级组和NYHA Ⅲ级组，差异有统计学意义（P＜0.05）。NYHA Ⅲ级组和NYHA Ⅳ级组LVEF低于NYHA Ⅱ级组，差异有统计学意义（P＜0.05）；NYHA Ⅳ级组LVEF低于NYHA Ⅱ级组和NYHA Ⅲ级组，差异有统计学意义（P＜0.05）。NYHA Ⅱ级组、NYHA Ⅲ级组、NYHA Ⅳ级组心电图T波振幅在II、V4、V5、V6导联均逐渐降低，以NYHA Ⅳ级组降低最明显，差异有统计学意义（P＜0.05）。超声心动图参数LVESV、LVESD、LVEDV、LVEDD与DCM患者心功能分级严重程度均呈正相关（r＝0.486、0.514、0.473、0.522，均P＜0.001）；LVEF与DCM患者心功能分级严重程度均呈负相关（r＝0.504，P＜0.001）。心电图T波振幅在II、V4、V5、V6导联与DCM患者心功能分级严重程度均呈负相关（r＝0.438、0.465、0.530、0.512，均P＜0.001）。超声心动图联合心电图T波振幅对DCM左室收缩功能具有较高的诊断价值（AUC＝0.922，95% CI：0.845-0.998，P＜0.001），显著优于单独应用超声心动图对DCM左室收缩功能的诊断价值（AUC＝0.863，95% CI：0.757-0.970，P＜0.001）和单独应用心电图T波振幅对DCM左室收缩功能的诊断价值（AUC＝0.706，95% CI：0.560-0.853，P＝0.024）。结论超声心动图联合心电图T波振幅可作为评估DCM左室收缩功能的重要指标，为临床治疗提供参考依据

Abstract

Objective:To investigate the value of echocardiography combined with ECG T wave amplitude in the evaluation of left ventricular systolic function in dilated cardiomyopathy (DCM).Methods:Eighty patients diagnosed with DCM in our hospital from April 2018 to December 2022 were selected as subjects

and were divided into NYHA Class Ⅱ group (n=28)

NYHA class Ⅲ group (n=26) and NYHA class Ⅳ group (n=26) according to New York College of Cardiology (NYHA) cardiac function grade.??All patients underwent echocardiography and simultaneous 12-lead combined table electrocardiogram.??Spearman rank correlation was used to analyze the correlation between T-wave amplitude of echocardiography and electrocardiogram and severity of DCM cardiac function classification.??ROC curve was used to analyze the diagnostic efficacy of echocardiography combined with T-wave amplitude of electrocardiogram in evaluating left ventricular systolic function of DCM. Results:LVESV

LVESD

LVEDV and LVEDD in NYHA Ⅲ and Ⅳ groups were higher than those in NYHA Ⅱ group

and the difference was statistically significant (P < 0.05).?LVESV

LVESD

LVEDV and LVEDD in NYHA grade Ⅳ group were higher than those in NYHA grade Ⅱ and NYHA grade Ⅲ groups

and the difference was statistically significant (P<0.05).?LVEF in NYHA Ⅲ and Ⅳ groups was lower than that in NYHA Ⅱ group

and the difference was statistically significant (P < 0.05).??The LVEF of NYHA grade Ⅳ group was lower than that of NYHA grade Ⅱ and NYHA grade Ⅲ groups

and the difference was statistically significant (P<0.05).?The T wave amplitude of ECG in NYHA Grade Ⅱ

NYHA Grade Ⅲ and NYHA grade Ⅳ groups decreased gradually at the II

V5 and V6 leads

and the decrease was most obvious in NYHA grade Ⅳ group

the difference was statistically significant (P<0.05).??Echocardiogram parameters LVESV

LVESD

LVEDV

LVEDD were positively correlated with the severity of cardiac function classification in DCM patients (r=0.486

0.514

0.473

0.522

all P<0.001).?There was a negative correlation between LVEF and severity of cardiac function classification in DCM patients (r=0.504

P<0.001).Ecg T-wave amplitude was negatively correlated with severity of cardiac function classification in II

V6 leads (r=0.438

0.465

0.530

0.512

all P<0.001).?Echocardiography combined with ECG T-wave amplitude had a higher diagnostic value for left ventricular systolic function of DCM (AUC=0.922

95%CI: 0.845-0.998

P<0.001)

which was significantly better than that of echocardiography alone (AUC=0.863

95%CI:??0.7577-0.970

P<0.001) and ECG T-wave amplitude alone in the diagnosis of left ventricular systolic function in DCM (AUC=0.706

95%CI: 0.560-0.853

P=0.024)?.Conclusion:Echocardiography combined with electrocardiogram T-wave amplitude can be used as an important index to evaluate left ventricular systolic function in DCM

and provide reference for clinical treatment.

关键词

超声心动图心电图T波振幅扩张型心肌病左室收缩功能

Keywords

Ultrasonic?cardiogramEcg T-wave amplitudeDilated cardiomyopathyLeft?ventricular?systolic?function

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