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目的室性心动过速(室速)是器质性心脏病猝死的主要机制。微伏级T波电交替(mi-crovolt Twave alternans,MTWA)是近年来无创评价和预测室速/心室颤动(室颤)及心脏性猝死的新方法。本研究的目的是探讨MTWA与室速的关系及其临床意义。方法用system剑桥心脏诊断系统(Cambridge Heart.HeartwaveTM),以频谱法检测45例健康志愿者及82例可疑室性心律失常者(其中有资料记载的室速48例)的MTWA。结果MTWA阳性主要见于陈旧性心肌梗死、冠心病、心肌病等,它与室速有一定的相关性(r=0.37,P<0.01)。器质性心脏病室速组MTWA阳性率高于非器质性心脏病室速组(P<0.01),非器质性心脏病室速组MTWA阳性率与健康人组差异无统计学意义(P>0.05)。MTWA诊断器质性心脏病室速的敏感性75.00%,特异性92.10%,诊断符合率87.03%。结论MTWA与器质性心脏病室速相关,可用于室速患者的危险分层。
The purpose of ventricular tachycardia (VT) is the main mechanism of structural heart disease sudden death. In recent years, mi-crovolt Twave alternans (MTWA) is a new method for noninvasive evaluation and prediction of ventricular tachycardia / ventricular fibrillation (VF) and sudden cardiac death. The purpose of this study is to investigate the relationship between MTWA and VT and its clinical significance. Methods The MTWA of 45 healthy volunteers and 82 suspected ventricular arrhythmias (including 48 cases of ventricular tachyarrhythmias) were detected by the system Cambridge Heart Diagnostic System (Cambridge Heart. HeartwaveTM). Results MTWA positive mainly in old myocardial infarction, coronary heart disease, cardiomyopathy, and it has a certain correlation with VT (r = 0.37, P <0.01). The positive rate of MTWA in patients with ventricular tachycardia was higher than that of non-organic heart disease (P <0.01), and there was no significant difference between MTWA positive rate and non-essential heart disease (P> 0.05) ). The sensitivity and specificity of MTWA in diagnosing ventricular tachycardia were 75.00% and 92.10%, respectively. The diagnostic accuracy was 87.03%. Conclusions MTWA is associated with ventricular tachycardia and ventricular tachycardia and can be used for risk stratification in patients with VT.