Widened QRS-T Angle May Be a Measure of Poor Ventricular Stretch During Exercise Among On-duty Firefighters.
Widened QRS-T Angle May Be a Measure of Poor Ventricular Stretch During Exercise Among On-duty Firefighters.
复制标题
QRS-T 角增宽可能是值班消防员运动期间心室舒张不良的衡量标准。
DOI：
10.1097/jcn.0000000000000554
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Carey,MaryG
中科院分区：
文献类型：
--
作者：
Dzikowicz,DillonJ;Carey,MaryG
背景：空间QRS-T角是复极化异质性的测量指标，可能是心室健康状况不佳的预测指标。QRS-T角与运动时血压之间是否存在关系尚不清楚。目的：本研究的目的是评估QRS-T角与运动时血压的潜在关系，这可能是心室拉伸的指示。方法：采用动态12导联24小时动态心电图监测QRS-T角度测量，然后进行运动试验，分别在运动前、运动时和运动后2分钟记录血压（mm Hg）。通过减去最大血压和运动后2分钟血压来计算血压恢复。给出平均值（±标准差）和百分比。所有QRS-T角度与所有BP测量值之间进行Pearson相关性(r)。对QRS-T角度分类及各BP指标进行单因素方差分析。结果：111名消防员（95.5%为男性，平均年龄44岁）被纳入本分析。27%的消防员的QRS-T角度处于边缘（100-139）或变宽（≥140）。虽然方差分析无统计学意义，但QRS-T角与最大舒张压之间存在接近统计学意义的负相关(r= - 0.190， P=。QRS-T角度与运动后舒张压之间存在统计学意义相关(r= - 0.261， P=。008)。结论：QRS-T角与最大舒张压和运动后舒张压呈负相关。运动期间和运动后最大舒张压较低可能是心室拉伸不良的标志。空间QRS-T角变宽可能表示心室伸展不良。
Background:The spatial QRS-T angle is a measure of repolarization heterogeneity and may be a predictor of poor ventricular health. It is unknown whether a relationship exists between QRS-T angle and blood pressure (BP) during exercise.Objective:The purpose of this study was to evaluate the potential relationship between QRS-T angle and BP during exercise, which may be indicative of ventricular stretch.Methods:Ambulatory 12-lead 24-hour Holter electrocardiographic monitoring for QRS-T angle measurement was followed by exercise testing with BP (mm Hg) recordings taken preexercise, maximum achieved BP during exercise, and 2 minutes postexercise. Blood pressure recovery was calculated by subtracting the maximal and 2-minute postexercise BPs. Means (±standard deviation) and percentages are presented. Pearson correlations (r) among all QRS-T angles and all BP measures were performed. One-way analysis of variance was conducted on classification of QRS-T angle and all BP measures.Results:One hundred eleven firefighters (95.5% male; mean age, 44 years) were included in this analysis. Twenty-seven percent of the firefighters had either a borderline (100–139) or widened (≥ 140) QRS-T angle. Although the analysis of variance was not statistically significant, a near–statistically significant negative correlation existed between QRS-T angle and maximum diastolic BP (r=− 0.190, P=. 05), and a statistically significant relationship existed between QRS-T angle and postexercise diastolic BP (r=− 0.261, P=. 008).Conclusions:A negative correlation existed between QRS-T angle and maximal diastolic BP and postexercise diastolic BP. Lower maximum diastolic BP during and after exercise may be a sign of poor ventricular stretch. A widened spatial QRS-T angle may represent poor ventricular stretch.