Analysis on the predictive value of ST segment changes and planar QRS-T angle in dynamic electrocardiography for myocardial ischemia of coronary heart disease

WANG Huixin; LIN Chunyao; SU Yangang

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Analysis on the predictive value of ST segment changes and planar QRS-T angle in dynamic electrocardiography for myocardial ischemia of coronary heart disease

Treatise | 更新时间：2026-01-06

- Analysis on the predictive value of ST segment changes and planar QRS-T angle in dynamic electrocardiography for myocardial ischemia of coronary heart disease
- J Clin Electrocardiol Vol. 34, Issue 6, Pages: 423-427(2025)
- 作者机构：
  
  1.361006 福建厦门，复旦大学附属中山医院厦门医院心电图室（王惠歆，林春尧）
  2.200032 上海，复旦大学附属中山医院心内科（宿燕岗）
- 作者简介：
- 基金信息：
- DOI：
  CLC： R541.7;R540.4+1
- Received：10 July 2025，
  
  Accepted：21 November 2025，
  
  Published：28 December 2025
- 稿件说明：
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王惠歆, 林春尧, 宿燕岗. 动态心电图ST段改变、平面QRS-T夹角对冠心病心肌缺血的预测价值分析[J]. 临床心电学杂志, 2025, 34(6): 423-427.

WANG Huixin,LIN Chunyao,SU Yangang.Analysis on the predictive value of ST segment changes and planar QRS-T angle in dynamic electrocardiography for myocardial ischemia of coronary heart disease[J].J Clin Electrocardiol,2025,34(06):423-427.
王惠歆, 林春尧, 宿燕岗. 动态心电图ST段改变、平面QRS-T夹角对冠心病心肌缺血的预测价值分析[J]. 临床心电学杂志, 2025, 34(6): 423-427. DOI：

WANG Huixin,LIN Chunyao,SU Yangang.Analysis on the predictive value of ST segment changes and planar QRS-T angle in dynamic electrocardiography for myocardial ischemia of coronary heart disease[J].J Clin Electrocardiol,2025,34(06):423-427. DOI：

摘要

目的

探讨动态心电图ST段改变、平面QRS-T夹角对冠心病心肌缺血的预测价值。

方法

选取2020年10月~2023年10月复旦大学附属中山医院厦门医院心血管内科收治的83例冠心病患者为研究对象，根据冠状动脉造影结果将其分心肌缺血组为A组（

=39）和无心肌缺血组为B组（

=44）。分析ST段、平面QRS-T夹角对冠心病心肌缺血的预测价值。

结果

两组一般资料中A组年龄、糖尿病、高血脂发生率高于B组，差异有统计学意义（

0.05）。ST段压低时，A组ST段改变、平面QRS-T夹角

90°占比高于B组，差异有统计学意义（

0.05）；ROC曲线显示：ST段改变、平面QRS-T夹角及联合预测的AUC、准确度、灵敏度、特异度分别为（0.680、67.47%、62.50%、74.29%）、（0.666、66.27%、62.22%、71.05%）、（0.797、70.72%、78.08%、83.33%），联合预测冠心病心肌缺血的预测价值高于单独预测（

0.05）。

结论

动态心电图ST段改变、平面QRS-T夹角对冠心病心肌缺血均有一定预测价值，但需要其他检查辅助提高确诊冠心病心肌缺血的准确率。

Abstract

Objective To explore the predictive value of dynamic electrocardiogram ST segment changes and planar QRS-T angle for myocardial ischemia in coronary heart disease. Methods 83 patients with coronary heart disease admitted to the Department of Cardiovascular Medicine of Xiamen Hospital affiliated with Zhongshan Hospital of Fudan University from October 2020 to October 2023 were selected as the study subjects. According to the results of coronary angiography

they were divided into myocardial ischemia group (

=39) and non myocardial ischemi

a group (

=44). Analyze the predictive value of ST segment and QRS-T angle in predicting myocardial ischemia in coronary heart disease.

Results

In the general data of the two groups

the age

diabetes and hyperlipidemia rate of group A were higher than those of group B

and the difference was statistically significant (

0.05). When the ST segment is depressed

the proportion of ST segment changes and QRS-T angle

90 ° in group A is higher than that in group B

and the difference is statistically significant (

0.05); The ROC curve shows that ST segment changes

QRS-T angle in the plane

and AUC

accuracy

sensitivity

and specificity of joint prediction are (0.680

67.47%

62.50%

74.29%)

(0.666

66.27%

62.22%

71.05%)

and (0.797

70.72%

78.08%

83.33%)

respectively. The predictive value of joint prediction of coronary heart disease myocardial ischemia is higher than that of individual prediction (

0.05).

Conclusions

The changes in ST segment and QRS-T angle of dynamic electrocardiogram have certain predictive value for myocardial ischemia in coronary heart disease

but other examinations are needed to assist in improving the accuracy of diagnosing myocardial ischemia in coronary heart disease.

关键词

Keywords

references

中国医师协会放射医师分会 . 冠心病CT检查和诊断中国专家共识 [J ] . 中华放射学杂志 , 2024 , 58 ( 2 ): 135 - 149 .

LI Y T , ZHANG J . Disease burden and risk factors of ischemic heart disease in China during 1990-2019 based on the Global Burden of Disease 2019 report: A systematic analysis [J ] . Front Public Health , 2022 , 10 : 973317 .

MAO C Y , ZENG H S , ZHANG K D , et al . Automatic diagnosis of coronary artery stenosis by deep learning based on X-ray coronary angiography [J ] . Quant Imaging Med Surg , 2025 , 15 ( 11 ): 10626 - 10639 .

汪凤琴 , 张凯 , 齐治平 , 等 . 急性心肌梗死患者心电图平面QRS-T夹角变化及其与恶性心律失常相关性分析 [J ] . 中国实验诊断学 , 2021 , 25 ( 6 ): 808 - 813 .

PALANISWAMY C , SINGH T , ARONOW W S , et al . A planar QRS-T angle >90 degrees is associated with multivessel coronary artery disease in patients undergoing coronary angiography [J ] . Med Sci Monit , 2009 , 15 ( 12 ): MS31 - MS34 .

GANDHI K , ARONOW W S , DESAI H , et al . Patients with ischemic stroke have a higher prevalence of a planar QRS-T angle >90° than patients with transient ischemic attack [J ] . Med Sci Monit , 2010 , 16 ( 12 ): CR588 - CR592 .

胡大一 . 心血管内科学 [M ] . 第1版 . 北京 : 人民卫生出版社 , 2009 .

PARK H B , HEO R , ÓHARTAIGH B , et al . Atherosclerotic plaque characteristics by CT angiography identify coronary lesions that cause ischemia: a direct comparison to fractional flow reserve [J ] . JACC Cardiovasc Imaging , 2015 , 8 ( 1 ): 1 - 10 .

HOUSTON M , MINICH D , SINATRA S T , et al . Recent science and clinical application of nutrition to coronary heart disease [J ] . J Am Coll Nutr , 2018 , 37 ( 3 ): 169 - 187 .

HU X Y , ZHANG J L , YANG S , et al . Angiography-derived fractional flow reserve versus intravascular ultrasound to guide percutaneous coronary intervention in patients with coronary artery disease (FLAVOUR Ⅱ): a multicentre, randomised, non-inferiority trial [J ] . Lancet , 2025 , 405 ( 10488 ): 1491 - 1504 .

刘秀 , 孙艳秋 . 不同检查方式对心肌缺血的研究进展 [J ] . 临床医学进展 , 2022 , 12 ( 5 ): 4752 - 4757 .

胡夫渠 , 严卫国 , 彭杰成 , 等 . 动态心电图ST段、T波变化联合冠状动脉CT血管成像在冠心病诊断中的应用 [J ] . 中国医药导报 , 2022 , 19 ( 32 ): 63 - 66 .

YU Q X , YU S Y . The value of combined detection of serum BNP, cardiac troponin-I and dynamic electrocardiogram in early clinical diagnosis and prognosis of patients with acute myocardial infarction [J ] . Discov Med , 2024 , 36 ( 182 ): 598 - 603 .

CHEN P , WU T , PENG Q H , et al . Application value between dynamic electrocardiogram and MSCT myocardial perfusion imaging in the diagnosis of myocardial ischemia in coronary heart disease [J ] . Ann Palliat Med , 2021 , 10 ( 10 ): 10720 - 10725 .

董宁 . 动态心电图QTc间期对冠心病病人心肌缺血发作的预测价值 [J ] . 中西医结合心脑血管病杂志 , 2019 , 17 ( 12 ): 1884 - 1887 .

祝云 . 动态心电图在无症状性心肌缺血诊断中的临床意义 [J ] . 山西医药杂志 , 2022 , 51 ( 17 ): 1987 - 1990 .

齐惠英 , 郑刚 . 平面QRS-T夹角与慢性心功能不全的临床分析 [J ] . 中国心血管杂志 , 2020 , 25 ( 1 ): 18 - 21 .

EYUBOGLU M . Frontal plane QRS-T angle in the monitoring of intravenous amiodarone infusion for pharmacological cardioversion of acute atrial fibrillation [J ] . J Clin Pharm Ther , 2021 , 46 ( 3 ): 731 - 737 .

EVSEN A , KARAHAN M Z . The significance of frontal plane QRS-T angle for estimating non-dipper hypertension [J ] . Cureus , 2022 , 14 ( 12 ): e32890 .

毕胜男 , 张建秋 . 平面QRS-T夹角在急性前壁心肌梗死诊治中的应用 [J ] . 实用心电学杂志 , 2020 , 29 ( 3 ): 170 - 172 .

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