| Objective : Cardiac repolarization ECG is playing more and more important role in the diagnosis of coronary heart disease. Nowadays, it is required to take a holistic approach of ST-T abnormalities on ECG, however, there are few researches in this area. The aim of our study is to investigate the diagnostic value of ST-T abnormalities and to find out if it is superior than the other indexes for diagnostic of the coronary heart disease.Methods:Clinical data of 385 cases of coronary heart disease were reported after diagnostic coronary angiography between January 2012 to December 2013 in our hospital and confirmed by angiography. Coronary stenosis ≥50% was detected as single vessel disease, <50% was non-coronary heart disease patients. Resting ECG data and other risk factors of patients were collected: 1. body mass index >25Kg/m2, 2. systolic blood pressure > 140 mm Hg, diastolic blood pressure >90mm Hg, blood pressure measurement in the morning resting blood pressure prevail, patients do not need long-term medication withdrawal, measured as two unsuspecting doctors per person the individual measurements averaged, 3.triglycerides >1.7mmol/L, Highdensity lipoprotein <1.8mmol/L, 4.fasting glucose >6.1mmol/L, there is non-stop with diabetes hypoglycemic drugs, 5. smoking history, 6. previous history of diabetes, history of hypertension. A ST-T abnormality was diagnosed if the subject had any of the following criteria:(1) a mild ST-segment abnormality exhibiting a flat T wave(code 5-3 or 5-4), or a negative or biphasic T wave(negative-positive type) with a negative phase <1:0mm(code 5-3),and(2) a severe ST-segment abnormality exhibiting a negative or biphasic T wave(negative-positive type) with a negative phase 1:0mm(code 5-1 or 5-2), horizontal or downward sloping ST-segment depression 0:5 mm(code 4-1or 4-2), or upward sloping ST depression 1:0mm(code 4-4).Explicit exclusion of left ventricular hypertrophy and myocardial infarction-induced ST-T changes. In order to investigate the association between the severity of CHD and ECG, data of ST-T variation was classified according to the degree of clinical situation of patients with positive coronary angiography(coronary stenosis ≥50%). The stratified analysis was carried out according to the age and weight. Statistics analyses were performed by SPSS 19.0 software. A p-value of <0.05 was considered significant.Result: In the 385 patients with coronary positive angiography, coronary angiography were abnormal in 297 cases, of which ECG were abnormal in 177 cases; coronary angiography were normal in 88 cases, with ECG abnormality in 30 cases. These electrocardiographic abnormalities had a statistical significance(P<0.05).There were 97 cases with single vessel disease in the coronary angiography abnormal patients, with ECG abnormal in 48 cases, while normal in 49 cases. 200 cases were detected as multivessel disease, of which ECG were abnormal in 127 cases(P<0.05). In logistic regression analysis, age and body mass index were further stratified. Cardiovascular risks such as sex, smoking history, history of diabetes, hypertension have different effects on coronary heart disease, and ECG ST-T changes have better prediction for judging the severity of coronary artery disease.Conclusion: The Minnesota Code was used based on computer-based electrocardiogram(ECG) diagnosis. ST-T abnormalities have diagnostic value in coronary heart disease. In the patients of coronary heart disease, ST-T abnormalities have diagnostic value for multivessel lesions. Various risk factors for coronary heart disease, such as age, sex, history of diabetes, hypertension, body mass index, history of smoking, have different severity impact on coronary artery disease. The presence of ECG ST-T abnormalities has a high positive rate of multivessel disease, contrast to those without the changes. |
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