一种预测冠状动脉钙化严重程度的新型心电图指标。

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Serkan Duyuler, Koray Arslan, Raif Can Karabulut, Atik Aksoy, Mustafa Dağlı, Pınar Türker Duyuler
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引用次数: 0

摘要

目的:心电图(ECG)仍然是心脏病学的重要工具。冠状动脉钙(CAC)评分,通过计算机断层扫描测量,是一个公认的心血管风险预测指标。然而,它的成本和可用性限制了它的广泛使用。本研究引入了一种新的基于心电图的指标PARLA(通过QRS-T角度和校正QT长度评估预测缺血)指数,结合QTc间隔和QRS-T (fQRS-T)角来评估其与CAC严重程度的关系。方法:这项回顾性的横断面研究纳入了接受心电图和冠状动脉ct血管造影的患者。排除标准包括传导异常、明显的瓣膜疾病、心肌病、既往冠状动脉干预和影响心电图参数的药物。PARLA指数定义为QTc区间与fQRS-T绝对角度之和。结果:595例患者(平均年龄53.4±11.6岁,女性39.5%)中,高CAC组患者年龄较大,高血压和糖尿病患病率较高,左室壁厚度较大。高cac组PARLA指数(440±26比465±37,P < 0.001)显著高于高cac组。多因素回归发现PARLA指数是CAC≥100的独立预测因子(OR: 1.021, P < .001)。ROC分析确定最佳PARLA指数临界值为450 (AUC: 0.705,敏感性:63%,特异性:66%)。结论:PARLA指数是一种新的、简单的心电图衍生参数,与CAC严重程度相关,可作为心血管风险分层的无创工具。未来的研究应验证其预后价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Electrocardiographic Index to Predict the Severity of Coronary Calcification.

Objective: Electrocardiogram (ECG) remains an essential tool in cardiology. Coronary artery calcium (CAC) score, measured via computed tomography, is a well-established predictor of cardiovascular risk. However, its cost and availability limit widespread use. This study introduces a novel ECG-based index, the PARLA (Prediction of Ischemia via Angle of QRS-T and corrected QT Length Assessment) Index, combining the QTc interval and frontal QRS-T (fQRS-T) angle, to assess its association with CAC severity.

Methods: This retrospective, cross-sectional study included patients who underwent ECG and coronary computed tomography angiography. Exclusion criteria encompassed conduction abnormalities, significant valvular disease, cardiomyopathy, prior coronary interventions, and medications affecting ECG parameters. The PARLA Index was defined as the sum of the QTc interval and absolute fQRS-T angle. Patients were classified based on CAC score: <100 (low CAC score) vs. ≥100 (high CAC score). Statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, assessed the predictive value of the PARLA Index for CAC severity.

Results: Among 595 patients (mean age 53.4 ± 11.6 years, 39.5% female), the high-CAC group had older age, higher prevalence of hypertension and diabetes, and greater left ventricular wall thickness. The PARLA Index was significantly higher in the high-CAC group (440± 26 vs. 465 ± 37, P < .001). Multivariate regression identified the PARLA Index as an independent predictor of CAC ≥100 (OR: 1.021, P < .001). ROC analysis determined an optimal PARLA Index cut-off of 450 (AUC: 0.705, sensitivity: 63%, specificity: 66%).

Conclusions: The PARLA Index is a novel, simple ECG-derived parameter that correlates with CAC severity and may serve as a noninvasive tool for cardiovascular risk stratification. Future studies should validate its prognostic value.

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来源期刊
Anatolian Journal of Cardiology
Anatolian Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.30
自引率
7.70%
发文量
270
审稿时长
12 weeks
期刊介绍: The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English. The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology. The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
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