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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 41-42页

作者： Rautaharju P.M. Kooperberg C. Larson J.C. LaCroix A. 刘宇 737 vista meadows dr Weston FL 33327 United States Dr.

Background -Information is limited about the independent prognostic value of repolarization abnormalities in women. Methods and Results -We evaluated hazard ratios for ECG variables for combined fatal and nonfatal coronary heart disease(CHD) events and for CHD mortality using Cox regression in 38 283 Women’s Health Initiative(WHI) participants during up to 9.2 years of follow-up. All risk models were adjusted for demographic, clinical, and therapeutic variables. Evaluated as single ECG variables, wide QRS/T angle and ECG-demonstrated myocardial infarction(ECG-MI) were the strongest predictors of CHD events, with hazard ratios(95%CI) of 1.90(1.50 to 2.42) and 1.62(1.29 to 2.03), respectively. Six other repolarization variables were also significant, strong predictors of CHD events. Wide QRS/T angle, ECG-MI, and QT prolongation appeared as dominant predictors when evaluated simultaneously with other ECG variables in a multiadjusted risk model. QRS/T angle, ECG-MI, and high QRS nondipolar voltage were the strongest predictors of CHD mortality, with hazard ratios of 2.70, 2.41, and 2.18, respectively. The risk increase ranged from 63%to 95%for the other 4 significant predictors. Five ECG abnormalities were identified as dominant mortality risk predictors: wide QRS/T angle, ECG-MI, high QRS nondipolar voltage, reduced heart rate variability, and QT prolongation(in the cardiovascular disease-free group only). Conclusions -Ventricular repolarization abnormalities in postmenopausal women are as important predictors of CHD events and CHD mortality as ECG-MI and other QRS abnormalities. Repolarization variables and QRS nondipolar voltage warrant attention in future investigations.

关键词：女性冠心病女性健康心电图异常冠心病死亡非致死性预测价值复极心血管疾病率变异性人口统

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维普期刊数据库

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绝经女性发生新发充血性心力衰竭以及全因死亡的心电图预测指标:女性健康倡议研究

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 42-42页

作者： Rautaharju P.M. Kooperberg C. Larson J.C. LaCroix A. 刘宇 737 vista meadows dr Weston FL 33327 United States Dr.

Background -Information is limited about ECG predictors of the risk of incident congestive heart failure(CHF), particularly in women without overt manifestations of cardiovascular disease(CVD).Methods and Results -We evaluated hazard ratios for incident CHF and all-cause mortality using Cox regression in 38 283 participants of the Women’s Health Initiative(WHI)during a 9-year follow-up. All risk models were adjusted for demographic and available clinical and therapeutic variables(multivariable-adjusted models). A backward selection procedure was used to identify dominant predictors among those that were significant as individual ECG predictors. Eleven ECG variables were significant predictors of incident CHF, with none of them having a significant interaction with baseline CVD status. From 6 dominant ECG predictors, wide QRS/T angle had a nearly 3-fold increased risk in multivariable-adjusted single ECG variable models. Two other repolarization variables, STV5 depression and high TV1 amplitude, and 2 QRS-related variables, QRS non-dipolar voltage and myocardial infarction(MI) by ECG, were all associated with ≈2-fold increase of incident CHF risk. Overall, 11 of the 12 ECG variables were significant predictors of all-cause mortality. Four variables had a significant interaction with CVD status requiring stratification. Three among these 4 were strong, dominant predictors in the CVD group: ECG MI, wide QRS/T angle, and low TV5 amplitude had risk increase from >2-fold to 3-fold, with considerably lower risks in the CVD-free group. Conclusions -Several repolarization variables in postmenopausal women are predictors of the risk of incident CHF and all-cause mortality as important as old ECG MI.

关键词：充血性心力衰竭全因死亡女性健康心电图指标心血管疾病交互作用复极多变量校正波振幅统计

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维普期刊数据库

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