Journal of electrocardiology最新文献

英文中文

Immediate changes in depolarization and repolarization after left bundle branch area pacing and atrioventricular nodal ablation 左束支区起搏和房室结消融后去极化和复极化的即时变化。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2025-01-01 DOI: 10.1016/j.jelectrocard.2024.153847

Mert Doğan MD, Uğur Canpolat MD, Cem Çöteli MD, Hikmet Yorgun MD, Kudret Aytemir MD

Background

Malignant arrhythmia due to ventricular depolarization and repolarization alterations after atrioventricular node (AVN) ablation is a known clinical entity. Here, we aimed to demonstrate the ventricular depolarization and repolarization changes in patients who underwent left bundle branch area pacing (LBBaP) and AVN ablation.

Methods

This is a single-center, retrospective preliminary study (n = 10). All patients underwent single-chamber pacemaker implantation with LBBaP before the AVN ablation procedure. Electrocardiographic (ECG) parameters [QRS duration (QRSd), QTc (Fridericia formula), Tp-e, and JT interval] were measured and analyzed before and after the procedure.

Results

The mean age of the study population was 67.1 ± 8.88 years, and 70 % of the patients were female. 60 % of the patients had AF, and 40 % of them had atrial tachycardia during the procedures. Eight patients had undergone more than two catheter ablations before the procedure. The QT interval (263.47 ± 26.79 vs. 416.14 ± 36.31 msec) and QRSd (93.3 ± 7.3 vs. 122.32 ± 21.16 msec) were prolonged when the patient's ECG parameters were analyzed. Still, the Tp-Te interval (75.57 ± 18.62 vs. 80.93 ± 17.35 msec) did not change, and the QTc (Fridericia formula) interval (425 ± 29.82 vs. 461.70 ± 35.33 msec) did not show a significant difference.

Conclusion

Malignant arrhythmia may occur due to ventricular depolarization and repolarization changes after the AVN ablation procedure. This study showed no significant change in Tp-e and QTc durations previously defined for malignant arrhythmia development. At the same time, JT time, which indicates ventricular repolarization duration, did not show a significant difference. LBBaP is more physiological and safer for patients planning to undergo AVN ablation.

背景：房室结（AVN）消融后心室去极化和复极化改变引起的恶性心律失常是一个已知的临床实体。在这里，我们的目的是证明左束分支区域起搏（LBBaP）和AVN消融患者心室去极化和复极化的变化。方法：这是一项单中心、回顾性初步研究（n = 10）。所有患者在AVN消融前均行单室起搏器植入LBBaP。测量并分析术前、术后心电图参数[QRS持续时间（QRSd）、QTc （Fridericia公式）、Tp-e、JT间期]。结果：研究人群平均年龄为67.1±8.88岁，女性占70%。在治疗过程中，60%的患者有房颤，40%的患者有房性心动过速。8名患者在手术前接受了两次以上的导管消融。分析心电图参数时QT间期（263.47±26.79比416.14±36.31 msec）延长，QRSd（93.3±7.3比122.32±21.16 msec）延长。Tp-Te区间（75.57±18.62 vs. 80.93±17.35 msec）没有变化，QTc （Fridericia公式）区间（425±29.82 vs. 461.70±35.33 msec）无显著差异。结论：AVN消融后室性去极化和复极化改变可导致恶性心律失常。该研究显示，先前定义为恶性心律失常发展的Tp-e和QTc持续时间没有显著变化。与此同时，反映心室复极持续时间的JT时间无显著差异。对于计划行AVN消融的患者，LBBaP更具生理性和安全性。

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引用次数: 0

Mortality in Modena 摩德纳的死亡率。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2025-01-01 DOI: 10.1016/j.jelectrocard.2024.153852

Mario Jorge Mc Loughlin MD

引用次数: 0

An ECG-based machine-learning approach for mortality risk assessment in a large European population 一种基于心电图的机器学习方法，用于评估大量欧洲人口的死亡风险。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2025-01-01 DOI: 10.1016/j.jelectrocard.2024.153850

Martina Doneda , Ettore Lanzarone , Claudio Giberti , Cecilia Vernia , Andi Vjerdha , Federico Silipo , Paolo Giovanardi

Aims

Through a simple machine learning approach, we aimed to assess the risk of all-cause mortality after 5 years in a European population, based on electrocardiogram (ECG) parameters, age, and sex.

Methods

The study included patients between 40 and 90 years old who underwent ECG recording between January 2008 and October 2022 in the metropolitan area of Modena, Italy. Exclusion criteria established a patient cohort without severe ECG abnormalities, namely, tachyarrhythmias, bradyarrhythmias, Wolff-Parkinson-White syndrome, second- or third- degree AV block, bundle-branch blocks, more than three premature beats, poor signal quality, and presence of pacemakers and implantable cardioverter- defibrillators. Mortality was assessed using a set of logistic regression models, differentiated by age group, to which the Akaike Information Criterion was applied. Model fitting was evaluated using confusion matrix-related performance metrics, the area under the receiver operating characteristic (ROC) curve (AUC), and the predictive significance against the no-information rate (NIR).

Results

53692 patients were enrolled, of whom 14353 (26.73 %) died within 5 years of ECG registration. The logistic regression model distinguished between those who died and those who survived based on the predicted mortality probability for all age groups, obtaining a significant difference between the predicted mortality and the NIR in 14 of the 55 age groups. Good accuracy and performance metrics were observed, resulting in an average AUC of 0.779.

Conclusions

The proposed model showed a good predictive performance in patients without severe ECG abnormalities. Therefore, this study highlights the potential of ECGs as prognostic rather than diagnostic tools.

目的：通过简单的机器学习方法，我们旨在根据心电图（ECG）参数、年龄和性别评估欧洲人群5年后全因死亡率的风险。方法：该研究纳入了2008年1月至2022年10月在意大利摩德纳大都会区进行心电图记录的40至90岁患者。排除标准建立了一个没有严重心电图异常的患者队列，即心律失常过速、慢速心律失常、沃尔夫-帕金森-怀特综合征、二度或三度房室传导阻滞、束支传导阻滞、三次以上早搏、信号质量差、存在起搏器和植入式心律转复除颤器。使用一组逻辑回归模型评估死亡率，按年龄组区分，并应用赤池信息标准。模型拟合通过混淆矩阵相关性能指标、受试者工作特征（ROC）曲线下面积（AUC）和对无信息率（NIR）的预测显著性进行评估。结果：53692例患者入组，其中14353例（26.73%）在心电图登记后5年内死亡。logistic回归模型根据所有年龄组的预测死亡率概率对死亡和存活进行区分，55个年龄组中有14个年龄组的预测死亡率和NIR之间存在显著差异。观察到良好的准确性和性能指标，导致平均AUC为0.779。结论：该模型对无严重心电图异常的患者具有良好的预测效果。因此，本研究强调了心电图作为预后而非诊断工具的潜力。

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引用次数: 0

MrSeNet: Electrocardiogram signal denoising based on multi-resolution residual attention network MrSeNet：基于多分辨率剩余注意网络的心电图信号去噪。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-27 DOI: 10.1016/j.jelectrocard.2024.153858

Zhen Wang , Hanshuang Xie , Yamin Liu , Huaiyu Zhu , Hongpo Zhang , Zongmin Wang , Yun Pan

Electrocardiography (ECG) is a widely used, non-invasive, and cost-effective diagnostic method that plays a crucial role in the early detection and management of cardiac conditions. However, the ECG signal is easily disrupted by various noise signals in the real world, leading to a decrease in signal quality and potentially compromising accurate clinical interpretation. With the goal of reducing noise in ECG signals, this research proposes an end-to-end multi-resolution deep learning network with attention mechanism, namely the MrSeNet to perform effective denoising of ECG data. Our MrSeNet fuses features at different scales for effective denoising with the squeeze-and-excitation module to enhance the features of the ECG signal channel. CPSC2018 database and the MIT-BIH database were used to verify the validity of the model by adding different intensity noises based on NSTDB. Using Pearson correlation coefficient, signal-to-noise ratio, and root mean square error performance evaluation model, the experimental results show that MrSeNet performs better than the traditional method, the model can achieve a good denoising effect to different degrees of noise signal data, and has a good future application prospect.

心电图（Electrocardiography， ECG）是一种应用广泛、无创、低成本的诊断方法，在心脏疾病的早期发现和治疗中起着至关重要的作用。然而，在现实世界中，心电信号很容易受到各种噪声信号的干扰，导致信号质量下降，并可能影响准确的临床解释。为了降低心电信号中的噪声，本研究提出了一种具有注意机制的端到端多分辨率深度学习网络MrSeNet对心电数据进行有效去噪。我们的MrSeNet融合了不同尺度的特征，通过压缩和激励模块有效地去噪，以增强心电信号通道的特征。利用CPSC2018数据库和MIT-BIH数据库，在NSTDB基础上加入不同强度噪声，验证模型的有效性。利用Pearson相关系数、信噪比和均方根误差性能评价模型，实验结果表明，MrSeNet的性能优于传统方法，该模型对不同程度的噪声信号数据都能达到良好的去噪效果，具有良好的未来应用前景。

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引用次数: 0

Electrocardiographic marker of ventricular action potential triangulation (the simulation study) 心室动作电位三角测量的心电图标记（模拟研究）。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-27 DOI: 10.1016/j.jelectrocard.2024.153857

Natalia V. Arteyeva PhD , Oleg E. Osadchii MD, PhD

Background

The aim of this simulation was to examine the utility of a novel ECG-based index of cardiac action potential (AP) triangulation, the Tstart-to-Tpeak (TsTp) interval-to-JTstart (JTs) interval ratio, for assessment of changes in AP profile imposed through variations in the duration of the plateau phase and the phase 3 repolarization.

Methods

ECGs were simulated using a realistic rabbit model based on experimental data. The AP plateau was measured at APD30, and the phase 3 was assessed as APD90-to-APD30 difference (AP durations at 90 % and 30 % repolarization, respectively). AP triangulation was quantified as (APD90-APD30)-to-APD30 ratio. The baseline durations of AP plateau and phase 3 were modified through (1) 50 % shortening, (2) 50 % to 100 % lengthening, and (3) concurrent, non-uniform lengthening in both the AP plateau and phase 3, replicating the long QT syndrome type 2 (LQT2) and type 3 (LQT3) models.

Results

When simulating the isolated changes in either the AP plateau or the phase 3 durations, the (APD90-APD30)-to-APD30 ratios were the same for all model cells. The TsTp/JTs ratios calculated from the simulated ECGs closely approximated the (APD90-APD30)-to-APD30 ratios, despite the lead-to‑lead variability in TsTp and JTs intervals. When simulating the concurrent changes in AP plateau and the phase 3, the (APD90-APD30)-to-APD30 ratios were variable in cells from different layers across the ventricular wall. Nevertheless, the TsTp/JTs ratios were found to be within the range of the minimum-to-maximum values for the (APD90-APD30)-to-APD30 ratio.

Conclusions

The TsTp interval-to-JTs interval ratio can serve as an electrocardiographic marker of cardiac AP triangulation.

背景：本模拟的目的是研究一种新的基于ecg的心脏动作电位（AP）三角测量指数的效用，即tstart -to- peak （TsTp）间隔与JTs （JTs）间隔比，用于评估通过平台期和第3期复极化持续时间的变化而施加的AP谱变化。方法：根据实验数据，采用真实家兔模型模拟脑电图。在APD30时测量AP平台，第3阶段评估apd90与APD30的差异（分别为90%和30%复极时的AP持续时间）。AP三角剖分量化为(APD90-APD30)- apd30比值。AP平台期和3期的基线持续时间通过(1)缩短50%，(2)延长50%至100%，(3)在AP平台期和3期同时，不均匀延长，复制长QT综合征2型（LQT2）和3型（LQT3）模型。结果：在模拟AP平台期或3期持续时间的分离变化时，所有模型细胞的（APD90-APD30）与apd30之比相同。尽管TsTp和JTs间隔存在铅-铅差异，但通过模拟心电图计算的TsTp/JTs比率与(APD90-APD30)- apd30比率非常接近。在模拟AP平台期和第3期同时变化时，心室壁不同层细胞的APD90-APD30与apd30比值是不同的。然而，发现TsTp/JTs比率在（APD90-APD30）与apd30比率的最小至最大值范围内。结论：TsTp间期与jts间期之比可作为心脏AP三角测量的心电图指标。

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引用次数: 0

Acute myocardial infarction with ST elevation isolated to lead III (and aVR) 急性心肌梗死伴ST段抬高分离至III导联（和aVR）。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-26 DOI: 10.1016/j.jelectrocard.2024.153855

Yochai Birnbaum , Kjell Nikus

引用次数: 0

Case report: Improved detection of electrocardiographic abnormalities using precordial bipolar leads 病例报告：使用心前区双极导联改进心电图异常的检测。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-26 DOI: 10.1016/j.jelectrocard.2024.153856

Mario J. Mc Loughlin MD

引用次数: 0

Real-world evidence for passive video-based cardiac monitoring from smartphones used by patients with a history of AF 有房颤史的患者使用智能手机进行被动视频心脏监测的真实证据。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-26 DOI: 10.1016/j.jelectrocard.2024.153860

J.-P. Couderc, A. Page, M. Lutz, T. Pham, G.R. Tsouri, B. Hall

Passive cardiac monitoring has become synonymous with wearable technologies, necessitating patients to incorporate new devices into their daily routines. While this requirement may not be a burden for many, it is a constraint for individuals with chronic diseases who already have their daily routine. In this study, we introduce an innovative technology that harnesses the front-facing camera of smartphones to capture pulsatile signals discreetly when users engage in other activities on their device.

We conducted a clinical study to gather real world evidence that passive video-based cardiac monitoring is feasible and it can be used to gather daily information about cardiac status of patients with a history of atrial fibrillation (AF). The study involved 16 patients who used an application called HealthKam AFib (HK) on their Android smartphone for a period of 14 days. They also wore an ECG patch during the first 7 days that was used as a reference device. Subjects were asked to also perform self testing procedures using video selfies twice a day, but measurements were also collected in the background during normal device usage. The 16 subjects had the HK app installed on their device during an average time period of 12.8

\pm

2.3 days. On average, the measurement rate was 2.1

\pm

1.6 measurements per hour of utilization of the smartphone. Heart rate measurements were found to be highly accurate, with a mean error equal to −0.3 bpm. The study revealed that passive facial video monitoring collected reliable data in real-world conditions.

被动心脏监测已成为可穿戴技术的代名词，患者必须将新设备纳入日常生活。虽然这一要求对许多人来说可能不是负担，但对于已经有了自己日常生活习惯的慢性病患者来说，却是一种限制。在本研究中，我们介绍了一种创新技术，该技术利用智能手机的前置摄像头，在用户使用设备进行其他活动时悄悄捕捉脉动信号。我们进行了一项临床研究，以收集现实世界的证据，证明基于被动视频的心脏监测是可行的，而且可以用于收集有心房颤动（房颤）病史的患者的日常心脏状态信息。这项研究涉及 16 名患者，他们在安卓智能手机上使用了一款名为 HealthKam AFib (HK) 的应用程序，为期 14 天。在前 7 天，他们还佩戴了一个心电图贴片作为参考设备。受试者还被要求每天两次使用视频自拍进行自我测试，但测量结果也是在正常使用设备时在后台收集的。16 名受试者在设备上安装 HK 应用程序的平均时间为 12.8±2.3 天。智能手机的平均测量率为每小时 2.1±1.6 次测量。研究发现，心率测量非常准确，平均误差为-0.3 bpm。该研究表明，被动面部视频监控可在真实世界条件下收集到可靠的数据。

{"title":"Real-world evidence for passive video-based cardiac monitoring from smartphones used by patients with a history of AF","authors":"J.-P. Couderc, A. Page, M. Lutz, T. Pham, G.R. Tsouri, B. Hall","doi":"10.1016/j.jelectrocard.2024.153860","DOIUrl":"10.1016/j.jelectrocard.2024.153860","url":null,"abstract":"<div><div>Passive cardiac monitoring has become synonymous with wearable technologies, necessitating patients to incorporate new devices into their daily routines. While this requirement may not be a burden for many, it is a constraint for individuals with chronic diseases who already have their daily routine. In this study, we introduce an innovative technology that harnesses the front-facing camera of smartphones to capture pulsatile signals discreetly when users engage in other activities on their device.</div><div>We conducted a clinical study to gather real world evidence that passive video-based cardiac monitoring is feasible and it can be used to gather daily information about cardiac status of patients with a history of atrial fibrillation (AF). The study involved 16 patients who used an application called HealthKam AFib (HK) on their Android smartphone for a period of 14 days. They also wore an ECG patch during the first 7 days that was used as a reference device. Subjects were asked to also perform self testing procedures using video selfies twice a day, but measurements were also collected in the background during normal device usage. The 16 subjects had the HK app installed on their device during an average time period of 12.8<span><math><mo>±</mo></math></span>2.3 days. On average, the measurement rate was 2.1<span><math><mo>±</mo></math></span>1.6 measurements per hour of utilization of the smartphone. Heart rate measurements were found to be highly accurate, with a mean error equal to −0.3 bpm. The study revealed that passive facial video monitoring collected reliable data in real-world conditions.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153860"},"PeriodicalIF":1.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Spatial QRS-T angle can indicate presence of myocardial fibrosis in pediatric and young adult patients with hypertrophic cardiomyopathy 空间QRS-T角可提示小儿和青壮年肥厚性心肌病患者心肌纤维化的存在。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-26 DOI: 10.1016/j.jelectrocard.2024.153859

Anna Wålinder Österberg , Robert Jablonowski , Ingegerd Östman-Smith , Marcus Carlsson , Todd T. Schlegel , Henrik Green , Cecilia Gunnarsson , Eva Fernlund

Background

Myocardial fibrosis, expressed as late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR), is an important risk factor for malignant cardiac events in hypertrophic cardiomyopathy (HCM). However, CMR is not easily available, expensive, also needing intravenous access and contrast.

Objective

To determine if derived vectorcardiographic spatial QRS-T angles, an aspect of advanced ECG (A-ECG), can indicate LGE to appropriately prioritize young HCM-patients for CMR.

Methods

Young patients (age 7–31 years) with clinical HCM (N = 19) or genotype-positive but phenotype-negative (G+ P-) results (N = 6) and nine healthy volunteers were evaluated for LGE by CMR at a single centre between 2011 and 2018. A-ECG was performed within 4 months before and 6 months after CMR and evaluated for spatial mean and peaks QRS-T angles. ECG Risk-score and frontal, two-dimensional QRS-T angle were also calculated from the 12‑lead ECG.

Results

All QRS-T angles were significantly higher in the HCM group with LGE as compared to the HCM group without LGE, and the G+ P- and Healthy groups. Only HCM-patients showed LGE (11/19). The optimal cut-offs for indicating LGE were > 50° for the spatial peaks (AUC = 0.98 [95 %CI 0.95–1.00], sensitivity 100 %, specificity 93 %; p < 0.001), >80° for the spatial mean (AUC = 0.91; p < 0.001), and > 60° for the frontal QRS-T angles (AUC = 0.85; p < 0.001), and > 2 points for an established ECG risk-score (AUC = 0.90, p < 0.001).

Conclusion

A spatial peaks QRS-T angle >50° has excellent sensitivity and specificity as a marker of myocardial fibrosis in a young patients with HCM, and can be useful for management and follow-up of such patients.

背景：心肌纤维化，在心脏磁共振成像（CMR）上表现为晚期钆增强（LGE），是肥厚性心肌病（HCM）恶性心脏事件的重要危险因素。然而，CMR不容易获得，价格昂贵，还需要静脉注射和对比。目的：确定作为晚期心电图（A-ECG）的一个方面，衍生矢量心电图空间QRS-T角度是否可以指示LGE适当优先考虑年轻hcm患者进行CMR。方法：2011年至2018年，在单一中心采用CMR对临床HCM （N = 19）或基因型阳性但表型阴性（G+ P-）结果（N = 6）的年轻患者（7-31岁）和9名健康志愿者进行LGE评估。分别于CMR前4个月和CMR后6个月进行A-ECG，评估QRS-T空间均值和峰值角度。同时计算12导联心电图的风险评分和额位、二维QRS-T角。结果：合并LGE的HCM组各QRS-T角度均显著高于未合并LGE的HCM组、G+ P-组和健康组。只有hcm患者出现LGE（11/19）。空间峰显示LGE的最佳截止值为bbb50°（AUC = 0.98 [95% CI 0.95-1.00]），灵敏度100%，特异性93%；空间平均值为p 80°(AUC = 0.91；正面QRS-T角度为p60°(AUC = 0.85；结论：空间峰QRS-T角>50°作为年轻HCM患者心肌纤维化的标志物具有良好的敏感性和特异性，可用于此类患者的管理和随访。

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引用次数: 0

The role of telemetry monitoring: From diagnosing arrhythmia to predictive models of patient instability 遥测监测的作用：从诊断心律失常到病人不稳定的预测模型。

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology

Pub Date : 2024-12-25 DOI: 10.1016/j.jelectrocard.2024.153861

Ran Xiao PhD

Over the past sixty years, telemetry monitoring has become integral to hospital care, offering critical insights into patient health by tracking key indicators like heart rate, respiratory rate, blood pressure, and oxygen saturation. Its primary application, continuous electrocardiographic (ECG) monitoring, is essential in diverse settings such as emergency departments, step-down units, general wards, and intensive care units for the early detection of cardiac rhythms signaling acute clinical deterioration. Recent advancements in data analytics and machine learning have expanded telemetry's role from observation to prognostication, enabling predictive models that forecast inhospital events indicative of patient instability. This short communication reviews the current applications and benefits of telemetry monitoring, including its vital role in identifying arrhythmias and predicting conditions like sepsis and cardiac arrest, while also addressing challenges such as alarm fatigue and the economic impact on health systems. It further explores opportunities for developing algorithms to enhance the practical use of telemetry data in clinical settings.

在过去的60年里，遥测监测已经成为医院护理不可或缺的一部分，通过跟踪心率、呼吸频率、血压和血氧饱和度等关键指标，提供对患者健康状况的关键洞察。它的主要应用是连续心电图（ECG）监测，在急诊室、降压病房、普通病房和重症监护病房等不同环境中，对于早期发现心律信号的急性临床恶化至关重要。数据分析和机器学习的最新进展将遥测的作用从观察扩展到预测，使预测模型能够预测表明患者不稳定的院内事件。这篇简短的通讯回顾了遥测监测的当前应用和好处，包括它在识别心律失常和预测败血症和心脏骤停等疾病方面的重要作用，同时也解决了报警疲劳和对卫生系统的经济影响等挑战。它进一步探讨了开发算法的机会，以加强遥测数据在临床环境中的实际应用。

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