Annals of Noninvasive Electrocardiology最新文献

英文中文

Frontal Plane QRS – T Angle Is a Predictor of Ventricular Arrhythmia in Heart Failure With Preserved Ejection Fraction 额平面QRS - T角是保留射血分数的心力衰竭患者室性心律失常的预测因子

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-03-12 DOI: 10.1111/anec.70062

Çağrı Zorlu, Barış Açıkel, Sefa Erdi Ömür

Introduction

Various ventricular repolarization parameters are known to predict ventricular arrhythmias and mortality in various diseases. Although mortality in patients with heart failure with preserved ejection fraction (HFpEF) is similar to that in heart failure with reduced ejection fraction patients, studies on this subject are more limited. Therefore, it is important to evaluate the relationship between ventricular arrhythmias and mortality and ventricular repolarization parameters, especially the frontal plane QRS–T angle, in patients with HFpEF.

Methods

Electrocardiographic, echocardiographic, and laboratory data of 811 patients were evaluated, and the fQRST angle was calculated on ECG. The occurrence of ventricular tachycardia, ventricular fibrillation, or sudden death within a mean of 48 ± 12 months was recorded. Statistical significance was determined as p < 0.05.

Results

A total of 811 patients were evaluated, 180 patients in the cardiac event group and 631 patients in the no cardiac event group. NT-proBNP, La size, La volume index, Tp-e time, Tp-e/QTc ratio, and fQRS-T angle were statistically significantly higher in the cardiac event group. NT-proBNP level and fQRS-T angle were found to be independent predictors of mortality in multivariate cox analysis. According to ROC analysis, when QRS-T angle has a cut-off value of 58.63, its sensitivity is 81.2, and its specificity is 79.3. Kaplan-Meier analysis also found that when the fQRS-T angle was > 58.63, mortality was higher than at narrower angles.

Conclusions

According to our study, the fQRS-T angle, which can be easily and inexpensively calculated on ECG, predicts long-term ventricular arrhythmias in patients with HFpEF.

各种心室复极参数可以预测各种疾病的室性心律失常和死亡率。尽管保留射血分数（HFpEF）心力衰竭患者的死亡率与降低射血分数心力衰竭患者相似，但这方面的研究更为有限。因此，评价HFpEF患者室性心律失常与死亡率与心室复极参数，尤其是额平面QRS-T角的关系具有重要意义。方法对811例患者的心电图、超声心动图及实验室资料进行分析，计算心电图fQRST角。记录在平均48±12个月内发生室性心动过速、室性颤动或猝死的情况。p <； 0.05为有统计学意义。结果共评估811例患者，其中心脏事件组180例，无心脏事件组631例。心脏事件组NT-proBNP、La大小、La容积指数、Tp-e时间、Tp-e/QTc比值、fQRS-T角均显著增高。多因素cox分析发现NT-proBNP水平和fQRS-T角度是死亡率的独立预测因子。根据ROC分析，当QRS-T角度截断值为58.63时，其敏感性为81.2，特异性为79.3。Kaplan-Meier分析还发现，当fQRS-T角度为58.63时，死亡率高于较窄角度。结论fQRS-T角可预测HFpEF患者的长期室性心律失常，在心电图上计算简便、成本低。

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引用次数: 0

Predictive Value of Noninvasive Cardiac Function Monitoring Combined With GRACE Score for Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction 无创心功能监测联合GRACE评分对st段抬高型心肌梗死患者短期预后的预测价值

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-26 DOI: 10.1111/anec.70056

Jiayan Xin, Yingwu Liu, Meng Ning, Chong Zhang

Objective

To investigate the correlation between non-invasive cardiac function monitoring indexes and recent adverse prognosis in patients with STEMI. The hemodynamic indexes with high diagnostic value were selected to construct a new risk prediction model combined with GRACE scores, and the efficiency of the new prediction model was evaluated.

Methods

STEMI patients who met the inclusion and exclusion criteria were selected. All patients were followed for 6 months of major adverse cardiovascular events (MACE). The non-invasive cardiac function monitoring indexes were analyzed by univariate and multivariate logistic regression. The ROC curve was used to evaluate the accuracy of non-invasive cardiac function indexes predicting MACE. Then, a new risk prediction model was established and its prediction efficiency was evaluated by ROC curve.

Results

Patients were divided into MACE group (N = 69) and non-MACE group (N = 173), stroke volume (SV), cardiac output (CO), cardiac index (CI), cardiac time intervals (CTI), early diastolic filling rate (EDFR), end-diastolic volume (EDV), and systemic vascular resistance (SVR) were found to be significant predictors of recent MACE events in STEMI patients. Multivariate logistic regression analysis confirmed that indicators of noninvasive cardiac function were independent predictors. In addition, the combination of SV and CTI with the GRACE score has the potential to enhance the predictive accuracy for MACE.

Conclusion

Non-invasive hemodynamic indicators SV, CO, CI, CTI, EDFR, EDV and SVR can not only independently predict the risk of recent MACE in patients with STEMI, but can also be used as joint indicators to significantly improve the predictive ability of GRACE score.

目的探讨STEMI患者无创心功能监测指标与近期不良预后的相关性。选择具有较高诊断价值的血流动力学指标，结合GRACE评分构建新的风险预测模型，并对新预测模型的有效性进行评价。方法选择符合纳入标准和排除标准的STEMI患者。所有患者随访6个月的主要不良心血管事件（MACE）。采用单因素和多因素logistic回归分析无创心功能监测指标。采用ROC曲线评价无创心功能指标预测MACE的准确性。然后，建立了新的风险预测模型，并用ROC曲线评价其预测效率。结果将患者分为MACE组（N = 69）和非MACE组（N = 173），发现卒中容量（SV）、心输出量（CO）、心脏指数（CI）、心脏时间间隔（CTI）、早期舒张充盈率（EDFR）、舒张末期容积（EDV）和全身血管阻力（SVR）是STEMI患者近期MACE事件的重要预测因子。多因素logistic回归分析证实无创心功能指标为独立预测因子。此外，SV和CTI与GRACE评分的结合有可能提高MACE的预测精度。结论无创血流动力学指标SV、CO、CI、CTI、EDFR、EDV、SVR不仅可以独立预测STEMI患者近期MACE的发生风险，而且可以作为GRACE评分的联合指标，显著提高GRACE评分的预测能力。

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引用次数: 0

Predictive Value of Blood and Echocardiographic Indicators for Nonvalvular Atrial Fibrillation in Postmenopausal Women 血液和超声心动图指标对绝经后妇女非瓣膜性心房颤动的预测价值

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-25 DOI: 10.1111/anec.70053

Lei Song, Xiao-Ping Shen, Jian-Rong Cai, Hong-Lei Zhang, Gui-Ru Li, Jing Shi

Objective

To evaluate the association and predictive value of midregional pro-atrial natriuretic peptide (MR-proANP), bone morphogenetic protein (BMP-7), and left atrial diameter (LAD) with nonvalvular atrial fibrillation (NVAF) in postmenopausal women.

Methods

This retrospective study included 288 postmenopausal women treated at Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January 2022 to October 2024. Patients were categorized into the NVAF and control groups based on electrocardiogram findings. Observation indicators were LAD, MR-proANP, BMP-7, homocysteine (Hcy), and free thyroxine (FT4). Echocardiography excluded valvular disease and measured LAD. Serum biomarkers were quantified using ELISA. Logistic regression identified independent risk factors, and ROC curves assessed predictive value.

Results

Of the 288 participants, 175 (61%) had NVAF. MR-proANP (425.8 vs. 289.4 nmol/L, p < 0.001), and LAD (38.4 vs. 32.5 mm, p < 0.001) were significantly higher in the NVAF group, whereas BMP-7 levels were lower (2.22 vs. 2.67 pg/L, p < 0.001). Additionally, Hcy (13.59 vs. 11.64 nmol/L, p = 0.023) and FT4 (16.91 vs. 15.85 nmol/L, p = 0.014) levels were also significantly elevated in the NVAF group. Multivariate logistic regression showed MR-proANP (OR 1.005, 95% CI 1.001–1.008), BMP-7 (OR 0.338, 95% CI 0.226–0.504), and LAD (OR 1.291, 95% CI 1.205–1.383) as independent risk factors for NVAF. Combined ROC analysis for MR-proANP, BMP-7, and LAD demonstrated an area under the curve (AUC) of 0.803, indicating superior predictive sensitivity and specificity than one indicator alone.

Conclusion

MR-proANP, BMP-7, and LAD are independent risk factors for NVAF in postmenopausal women. Their combined measurement provides valuable predictive insights, aiding in clinical decision-making.

目的探讨中区域前房利钠肽（MR-proANP）、骨形态发生蛋白（BMP-7）、左房内径（LAD）与绝经后妇女非瓣膜性房颤（NVAF）的相关性及预测价值。方法对2022年1月至2024年10月在上海医科大学附属崇明医院接受治疗的绝经后妇女288例进行回顾性研究。根据心电图结果将患者分为非瓣膜性房颤组和对照组。观察指标为LAD、MR-proANP、BMP-7、同型半胱氨酸（Hcy）、游离甲状腺素（FT4）。超声心动图排除瓣膜疾病并测量LAD。采用ELISA对血清生物标志物进行定量分析。Logistic回归识别独立危险因素，ROC曲线评估预测价值。结果288名参与者中，175名（61%）患有非瓣膜性房颤。NVAF组MR-proANP （425.8 vs. 289.4 nmol/L, p < 0.001）和LAD （38.4 vs. 32.5 mm, p < 0.001）水平显著升高，而BMP-7水平较低（2.22 vs. 2.67 pg/L, p < 0.001）。此外，NVAF组Hcy （13.59 vs. 11.64 nmol/L, p = 0.023）和FT4 （16.91 vs. 15.85 nmol/L, p = 0.014）水平也显著升高。多因素logistic回归显示MR-proANP （OR 1.005, 95% CI 1.001-1.008）、BMP-7 （OR 0.338, 95% CI 0.226-0.504）和LAD （OR 1.291, 95% CI 1.205-1.383）为非瓣瓣性房颤的独立危险因素。MR-proANP、BMP-7和LAD的联合ROC分析显示，曲线下面积（AUC）为0.803，表明预测敏感性和特异性优于单独使用一项指标。结论MR-proANP、BMP-7、LAD是绝经后妇女非瓣瓣性房颤的独立危险因素。他们的综合测量提供了有价值的预测见解，有助于临床决策。

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引用次数: 0

Syncope Linked to QT-Interval Prolongation and Global T-Wave Inversion: A Clinical Case of Acute Pulmonary Embolism 与 QT 间期延长和全局 T 波倒置相关的晕厥：急性肺栓塞的临床病例。

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-14 DOI: 10.1111/anec.70049

Xue-Yan Zhang, Jing-Xiu Li, Min Gao, Xue-Qi Li, Ming-Yu Zhang

The incidence and mortality rates of acute pulmonary embolism (APE) are high in clinical emergencies, making early diagnosis and risk stratification crucial. Electrocardiogram (ECG) plays a significant role in guiding the diagnosis and differential diagnosis of pulmonary embolism. Acute pulmonary embolism can present with various ECG manifestations. The presence of pulmonary hypertension and increased right ventricular load in pulmonary embolism can lead to T wave inversion in the right cardiac lead. Additionally, some patients may exhibit a prolonged QT interval, which is associated with the pathophysiological processes resulting from both pulmonary hypertension and myocardial ischemia.

急性肺栓塞（APE）的发病率和死亡率在临床急诊中很高，因此早期诊断和风险分层至关重要。心电图对肺栓塞的诊断和鉴别诊断具有重要的指导作用。急性肺栓塞可表现为多种心电图表现。肺动脉高压的存在和肺动脉栓塞时右心室负荷的增加可导致右心导联T波倒置。此外，一些患者可能表现出QT间期延长，这与肺动脉高压和心肌缺血引起的病理生理过程有关。

引用次数: 0

Left Bundle Branch Pacing in a Pediatric Patient With Tricuspid Valve Replacement for a Complex Ebstein Anomaly 小儿三尖瓣置换术治疗复杂Ebstein异常的左束支起搏

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-11 DOI: 10.1111/anec.70057

Di Tian, Longfu Jiang, Jiabo Shen

This paper presents a unique case of successful implementation of left bundle branch pacing (LBBP) in a pediatric patient with third-degree atrioventricular block following tricuspid valve replacement for a complex Ebstein anomaly. The procedure was performed under real-time recording technique, and resulted in the resolution of the patient's symptoms. This case underscores the feasibility and potential benefits of LBBP in pediatric patients, particularly in those with complex congenital heart conditions and following valve replacement surgery. The successful implementation of LBBP in this case provides valuable insights and a reference for similar cases in the future.

本文提出了一个独特的案例，成功实施左束支起搏（LBBP）的儿童患者三尖瓣置换术后，复杂的Ebstein异常的三度房室传导阻滞。该过程是在实时记录技术下进行的，并导致患者症状的缓解。本病例强调了LBBP在儿科患者中的可行性和潜在益处，特别是那些患有复杂先天性心脏病和瓣膜置换术后的患者。本案例中LBBP的成功实施为今后类似的案例提供了有价值的见解和参考。

引用次数: 0

Application of Veno-Arterial ECMO Combined With Hemoperfusion in the Treatment of a Patient With Yunaconitine Poisoning: A Case Report 静脉-动脉ECMO联合血液灌流治疗乌头碱中毒1例

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-07 DOI: 10.1111/anec.70051

Zhuo Jiang, Yue Zhuang, Xueting Hu, Wei Chen, Fei Xia, Xiaoxia Hu, Aixiang Yang, Weiyi Tao

A 40-year-old man, after accidentally ingesting aconitine in a herbal remedy, suffered severe poisoning symptoms and was diagnosed with multiple arrhythmias. He quickly received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and hemoperfusion in the ICU, along with continuous renal replacement therapy (CRRT) to stabilize his internal environment. The treatment controlled the arrhythmias, restored heart function, and alleviated acidosis. The patient was discharged feeling well after 9 days. This combined therapy is valuable for severe aconitine poisoning, especially when specific antidotes are lacking, as it provides critical life support and effectively removes toxins.

一名40岁的男子在不小心摄入了一种草药中的乌头碱后，出现了严重的中毒症状，并被诊断出患有多种心律失常。他迅速在ICU接受静脉-动脉体外膜氧合（VA-ECMO）和血液灌流，同时持续肾替代治疗（CRRT）以稳定其内环境。治疗后心律失常得到控制，心功能得到恢复，酸中毒得到缓解。9天后出院，感觉良好。这种联合疗法对严重的乌头碱中毒很有价值，特别是在缺乏特定解毒剂的情况下，因为它提供了关键的生命支持并有效地去除毒素。

引用次数: 0

Chest Discomfort, Left Ventricular Hypertrophy, Global T-Wave Inversion, and Short PR Interval Points to a Particular Cardiac Condition. What Could Be the Diagnosis? 胸部不适、左心室肥大、全局 T 波倒置和 PR 间期短指向某种特定的心脏疾病。诊断可能是什么？

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-02-07 DOI: 10.1111/anec.70048

Jing-Xiu Li, Xin-Xin Di, Min Gao, Xue-Qi Li, Yan-Lin Wang, Jie Zheng

This article describes a 44-year-old female with Fabry disease presenting with a 7-year history of chest discomfort, extremity pain, and hypohidrosis. ECG revealed sinus bradycardia (52 bpm), a short PR interval (100 ms) with a delta wave, and a QRS complex (126 ms) showing a complete right bundle branch block. T-wave inversion and ST-segment depression were observed in leads I, AVL, II, aVF, and V2–V6. Genetic testing confirmed Fabry disease (GLA: c.700_702del). Short PR interval with left ventricular hypertrophy (LVH) poses a diagnostic challenge, requiring advanced imaging and genetic testing to differentiate Fabry disease from other cardiomyopathies.

这篇文章描述了一位44岁的女性法布里病，她有7年的胸部不适、四肢疼痛和出汗少的病史。心电图显示窦性心动过缓（52 bpm），短PR间隔（100 ms）伴delta波，QRS复合体（126 ms）显示完整的右束分支阻滞。导联I、AVL、II、aVF和V2-V6均出现t波反转和st段下降。基因检测证实法布里病（GLA: c.700_702del）。短PR间期伴左室肥厚（LVH）的诊断具有挑战性，需要先进的影像学和基因检测来区分法布里病和其他心肌病。

引用次数: 0

Arterial Stiffness and Markers of Atrial Myopathy 动脉僵硬和心房肌病标志物。

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-01-31 DOI: 10.1111/anec.70044

Magdalena Okrajni, Pyotr Platonov, Iram Faqir Muhammad, Fredrik Holmqvist, Johan Economou Lundberg, Anders Persson, Cecilia Kennbäck, Jeffrey S. Healey, Gunnar Engström, Linda S. Johnson

Background

Arterial stiffness, measured using carotid-femoral pulse wave velocity (c-f PWV) and heart rate-corrected augmentation index (Aix75), is associated with cardiovascular disease, and in some studies incident atrial fibrillation (AF). In this cross-sectional study, we aimed to investigate whether arterial stiffness is associated with markers of atrial myopathy, which refers to structural and electrical changes in the atria that indicate increased AF risk.

Methods

We included 1050 participants (age 57 ± 4.3 years, 47% males) from the population-based Swedish CArdioPulmonary bioImage Study with c-f PWV and Aix75 data. A random subsample (n = 331) underwent echocardiography. The association between arterial stiffness and atrial myopathy markers was studied using multivariable-adjusted negative binomial regression models for premature atrial complexes (PACs) on 24 h ECG, linear regression for P-wave duration and left atrial volume index (LAVi), and logistic regression models for abnormal P-wave terminal force in V1 (PWTFV1) and P-wave axis.

Results

Arterial stiffness was associated with fewer PACs: incidence rate ratio (IRR) 0.45 (95% CI: 0.31 to 0.65, p < 0.001) per 1 m/s increase in c-f PWV and IRR 0.66 (95% CI: 0.49 to 0.89, p = 0.01) per % increase in Aix75. There was no association between arterial stiffness and P-wave indices, OR 1.09 (95% CI: 0.85 to 1.40), p = 0.50 for abnormal PWTFV1, and β −0.003 (−0.10 to 0.09), p = 0.95 for P-wave duration, both per 1 m/s increase in c-f PWV.

Conclusions

Arterial stiffness, measured as either c-f PWV or Aix75, was associated with fewer PACs, whereas no association was found with P-wave indices. The association between arterial stiffness and atrial myopathy is complex and merits further study.

背景：动脉硬度，用颈-股脉波速度（c-f PWV）和心率校正增强指数（Aix75）测量，与心血管疾病相关，在一些研究中发生心房颤动（AF）。在这项横断面研究中，我们旨在调查动脉僵硬是否与心房肌病标志物相关，心房肌病是指心房结构和电变化，表明房颤风险增加。方法：我们纳入了1050名参与者（年龄57±4.3岁，47%男性），来自基于人群的瑞典心肺生物图像研究，使用c-f PWV和Aix75数据。随机抽样（n = 331）接受超声心动图检查。采用24 h心电图早衰房颤（PACs）的多变量调整负二项回归模型、p波持续时间和左心房容积指数（LAVi）的线性回归模型、p波V1末端力异常（PWTFV1）和p波轴的逻辑回归模型，研究动脉僵硬度与心房肌病标志物的关系。结果：动脉僵硬度与较少的PACs相关：发病率比（IRR） 0.45 （95% CI: 0.31至0.65,p）。结论：动脉僵硬度（以c-f PWV或Aix75测量）与较少的PACs相关，而与p波指数无关联。动脉僵硬和心房肌病之间的关系是复杂的，值得进一步研究。

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引用次数: 0

PR Interval as a Valuable Predictor of Tilt Table Test Results in Patients With Neurally Mediated Syncope PR间期作为神经介导性晕厥患者倾斜试验结果的一个有价值的预测因子。

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-01-31 DOI: 10.1111/anec.70054

Mohammad Hossein Nikoo, Roozbeh Narimani-Javid, Alireza Kamrava, Sasan Shafiei, Salma Nozhat, Hosein Fatemian, Ali Asadzadeh, Mehdi Motahari Moadab, Fatemeh Ghanbari, Alireza Arzhangzadeh

Background

Neurally mediated syncope (NMS) is the primary cause of temporary and self-limiting loss of consciousness. The tilt table test (TTT) has been consistently employed as a supplementary diagnostic tool for syncope evaluation. However, TTT requires specialized equipment, which is lacking in several emergency room and clinic environments. We hypothesized that patients susceptible to NMS may have higher parasympathetic tone. Thus, this study investigates the correlation between PR interval and Herat rate variability parameters as indicators of parasympathetic tone and TTT results.

Methods

We included 213 patients referred to our cardiology clinic with an impression of NMS in 2022 and 2023. Data was retrospectively collected from 24-h ambulatory electrocardiographic monitoring recordings, TTT results, and patients' history and physical examination records.

Results

The analysis of the PR interval revealed a mean duration of 155 ms (95% CI: 148.61, 161.39) in negative TTT patients and 164.21 ms (95% CI: 158.44, 169.97) in positive TTT patients, indicating a statistically significant difference between two groups (p = 0.035). We also found that patients with a PR interval duration exceeding 160 ms demonstrated a significantly higher prevalence of positive TTT compared to those with a PR interval duration of less than 160 ms (p < 0.001, OR: 3.911, 95% CI: 2.143, 7.140).

Conclusions

Our study suggests a PR interval longer than 160 milliseconds as a valuable tool for predicting TTT results and identifying patients at higher risk of NMS.

背景：神经介导性晕厥（NMS）是暂时性和自限性意识丧失的主要原因。倾斜台试验（TTT）一直被用作晕厥评估的辅助诊断工具。然而，TTT需要专门的设备，这在一些急诊室和诊所环境中是缺乏的。我们假设易受NMS影响的患者可能有更高的副交感神经张力。因此，本研究探讨了PR间隔和Herat率变异性参数作为副交感神经张力和TTT结果的指标之间的相关性。方法：我们纳入了2022年和2023年在我们心脏病科诊所转诊的213例有NMS印象的患者。回顾性收集24小时动态心电图监测记录、TTT结果、患者病史和体格检查记录。结果：TTT阴性患者PR间期平均为155 ms (95% CI: 148.61, 161.39)， TTT阳性患者PR间期平均为164.21 ms (95% CI: 158.44, 169.97)，两组间差异有统计学意义（p = 0.035）。我们还发现，与PR间隔时间小于160 ms的患者相比，PR间隔时间超过160 ms的患者TTT阳性发生率明显更高(p结论：我们的研究表明，PR间隔时间大于160 ms是预测TTT结果和识别NMS高风险患者的有价值工具。

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引用次数: 0

A Rare Case of Anterior Wall Combined With Inferior Wall Wellens Syndrome 罕见的前壁合并下壁韦伦斯综合征1例

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology

Pub Date : 2025-01-27 DOI: 10.1111/anec.70052

Lei Zhang

This article describes a woman who presented to the hospital with recurrent chest pain. The electrocardiogram revealed positive and negative biphasic T waves in the anterior and inferior leads, which subsequently deepened. Upon recurrence of chest pain, the T waves reverted to upright. Coronary angiography indicated the presence of three-vessel coronary artery disease. The occurrence of Wellens' T wave sign in the precordial leads frequently suggests left anterior descending artery disease, while the presence of positive and negative biphasic T waves in the inferior wall leads may also indicate lesions in the right coronary artery or left circumflex artery.

这篇文章描述了一个妇女谁提出了医院反复胸痛。心电图示前、下导联正、负双相T波，其后加深。胸痛复发后，T波恢复直立。冠状动脉造影显示存在三支冠状动脉疾病。心前导联出现Wellens T波征象常提示左前降支病变，而下壁导联出现正、负双相T波也可能提示右冠状动脉或左旋动脉病变。

引用次数: 0

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