最新刊期
卷 30 ， 期 1 ， 2021
- 摘要：<正>心脏植入电子装置（Cardiac Implantable Electronic Device,CIED）包括起搏器及植入式心律转复除颤器（Implantable Cardioverter Defibrillator,ICD）可以挽救多种心脏病患者的生命。植入装置相关的感染是最严重的并发症之一,该并发症有高发病率、高死亡率,同时大大增加医疗支出。尽管目前有一些公认的措施预防感染,比如静脉抗生素的应用,但是很多其他的管理措施仍然存在争议。因此,2020年由国际七个专业协会/组织合作完成的心律植入装置感染预防、诊断及处理专家共识推出。国际的七个协会包括欧洲心律协会（EHRA）、美国心律协会（HRS）、亚太心律协会（APHRS）、拉丁美洲心律协会（LAHRS）、欧洲心胸外科协会（EACTS）、欧洲临床微生物学和感染病协会（ESCMID）、国际心血管感染性疾病协会（ISCVID）。关键词：心脏植入电子装置;感染;囊袋感染2|39|0更新时间：2025-10-15
- 摘要：<正>用于QT间期心率校正的"Bazett公式"早已为临床医生所熟知,该公式以英国学者Henry Cuthbert Bazett的名字命名,于1920年提出,并一直应用于临床,现已逾百年。Bazett还有很多开创性的研究,主要是关于体温调节,循环和血容量调解等,他积极地采用有创导管进行人体实验,为人类心脏血液循环方面的研究做出了巨大的贡献。早期生平Henry Cuthbert Bazett于1885年出生于英格兰泰晤士河南岸的肯特郡西北部小镇Gravesend。Bazett曾就读于多佛大学,并在牛津的Wadham学院学习。1908年,他获得了文学和工商管理学学士学位,1910年获得医学博士学位（图1）,1911年获得皇家外科医学院（FRCS）专业外科医师资格,开始在伦敦的St. Thomas’s医院工作。Bazett于1912年获得Radcliffe旅行奖学金,在马萨诸塞州波士顿的哈佛大学度过了12个月的研究工作。随后他回到英国,成为牛津大学的一名病理学医生。在第一次世界大战期间,2|14|0更新时间：2025-10-15
- 摘要：Objective To compare the ECG features during sinus rhythm between arrhythmogenic right ventricular cardiomyopathy（ARVC） and idiopathic right ventricular outflow tract ventricular tachycardia（RVOT） in China. Methods The ECG features during sinus rhythm before treatment were reviewed in 21 patients diagnosed with ARVC in People’s Hospital of Peking University from 2008 to 2018 and 31 patients diagnosed with idiopathic right ventricular outflow tract ventricular tachycardia（RVOT） who also had radio frequency ablation from 2008 to2011. Results The mean duration of QRS（QRSd） of V1 lead in ARVC group was longer than that of RVOT（118.6±23.8 ms vs. 98.5±20.6 ms, p<0.05）. The difference of QRSd between lead V1 and lead I in ARVC was greater than that of RVOT（19.9±8.2 ms vs. 10.0±8.6 ms, p<0.05）. The difference of QRSd between lead V1 and lead V6 in ARVC was also greater than that of RVOT（20.5±9.7 ms vs. 7.3±8.2 ms, p<0.05）. The ratio of QRSd of lead V1 to lead V6 in ARVC was greater than that of RVOT（1.22±0.11 vs. 1.08±0.096, p<0.05）. Right precordial Epsilon waves were presented in 33.3% of ARVC patients, and 3.2% of RVOT patients, p<0.05. Right precordial fragmented QRS were presented in 42.9% of ARVC patients, while 12.9% of RVOT patients,p<0.001. Either right precordial Epsilon waves or fragmented QRS were presented in 71.4% of ARVC patients, while 16.1% of RVOT patients, p<0.001. Localized right precordial QRS prolongation was presented in 61.9% of ARVC patients, while 12.9% of RVOT patients, p<0.001.85.7% of the ARVC patients were positive with one of the above three presentation of the right precordial abnormal features, while 16.1% of RVOT patients, p<0.001. The morphology of QRS of lead V1 was different between two group.57.1% of ARVC patients presented r Sr（R） type, 33.3% presented r S type; while 83.9% of RVOT patients presented r S type, 12.9% presented r Sr（R） type. Conclusions Patients with right precordial Epsilon waves or fragmented QRS or localized right precordial QRS prolongation were more frequent in ARVC group than in RVOT group. The features of sinus rhythm ECG may have high value in differential diagnosis between ARVD and RVOT.关键词：Arrhythmogenic right ventricular cardiomyopathy;Idiopathic right ventricular outflow tachycardia;Electrocardiogram2|27|0更新时间：2025-10-15
- 摘要：Objective In order to understand the anxiety and possible risk factors of anxiety in elderly patients with atrial fibrillation in emergency department. Furthermore, it provides a theoretical basis for chronic disease management in elderly patients with atrial fibrillation. Methods According to the inclusion and exclusion criteria, 67 elderly patients with atrial fibrillation who were admitted to the emergency department of Peking University People’s Hospital from April 1, 2018 to June 1, 2018 were continuously selected, including 30 males and 37 females. The patient’s general condition and previous medical history data were collected, and the degree of anxiety was assessed by using the Zung Self-Rating Anxiety Scale（SAS）. Other blood biochemical indicators including lactate dehydrogenase,α-hydroxybutyrate dehydrogenase, creatine kinase, glucose, urea, creatinine, uric acid, albumin, serum sodium,serum potassium, D-dimer and echocardiography results etc. are also collected. According to SAS score, they are divided into anxiety group and non-anxiety group. Calculate the prevalence of anxiety in elderly patients with atrial fibrillation in emergency department; Single factor and multivariate logistic regression were used to analyze the possible related factors of anxiety in patients with atrial fibrillation, and the ROC curve was used to analyze the critical value of uric acid. Results The levels of uric acid and the number of people with gastroesophageal reflux in the anxiety group were significantly higher than those in the non-anxiety group, and the difference was statistically significant（p<0.05）. Multiple logistic regression analysis showed that uric acid was an independent risk factor for anxiety. Uric acid alone cannot be used as a diagnostic basis for anxiety. Conclusions The prevalence of anxiety in elderly patients with atrial fibrillation in emergency department is as high as 50.75%. In emergency elderly patients with atrial fibrillation, elevated uric acid may be a possible risk factor for anxiety in elderly patients with atrial fibrillation.关键词：Elderly;atrial fibrillation;Anxiety;Uric acid2|16|0更新时间：2025-10-15
- 摘要：Objective To explore the end-part changes and risk stratification of the QRS complex in the ECG of patients with STEMI. Methods A total of 76 patients with STEMI who were examined in our hospital from March2019 to March 2020 were selected. All patients underwent ECG examination. According to the QRS complex, 48 patients with unchanged QRS complexes were assigned into the control group. The 28 patients who had QRS changes were assigned as the study group. We analyzed the detection status of patients with terminal partial changes in QRS complexes of patients in each risk stratification, and compare the indicators of the two groups. Results The positive rate of high-risk patients was higher than that of middle-and low-risk patients（p<0.05）. There was no significant difference between the two groups in age, gender, and Ccr（p>0.05）. The study group’s risk score, CRP, random blood glucose, BNP, CK-MB, c TnI, Killip grade ≥2, the time from onset to treatment was longer than that of the control group（p<0.05）, and the number of LVEF and anterior wall infarction in the study group was lower than that in the control group（p<0.05）. Conclusions The ECG examination can be used as an effective risk assessment method in patients with STEMI.关键词：Acute ST-segment elevation myocardial infarction;Electrocardiogram;QRS complex;Risk stratification2|13|0更新时间：2025-10-15
- 摘要：Objective To analysis the 12-lead electrocardiogram T wave period（Tp-Te） and at the end of the period between QT dispersion degree（QTd） and the correlation between the severity of coronary heart disease（CHD）and the value of the diagnosis of coronary heart disease. Methods A retrospective analysis of 50 cases of healthy physical examination and the clinical data of 50 patients with coronary heart disease, for health group by physical examination, in patients with coronary heart disease（CHD） for coronary heart disease group, compared two groups of Tp-Te, the difference of QTd, analysis of Tp-Te, QTd and correlation between the severity of coronary heart disease（CHD）, and value to the diagnosis of coronary heart disease. Results Tp-Te and QTd CHD group were higher than in healthy group, the difference is statistically significant（p<0.05）. At the same time, the group of Tp-Te, QTd and coronary heart disease of coronary artery stenosis degree has significant positive linear correlation, statistical differences（p<0.05）. In addition, in the diagnosis of coronary heart disease, Tp-Te and QTd has a higher sensitivity,specificity and accuracy, and through the analysis of Tp-Te and QTd value to the diagnosis of coronary heart disease have a significantly（p<0.05）. Conclusions There is significant positive correlation between Tp-Te and QTd and the severity of coronary artery disease, and it has significant value for the diagnosis of coronary heart disease.关键词：Electrocardiogram;Repolorization;QTc interval dispersion;Coronary heart disease2|13|0更新时间：2025-10-15
- 摘要：Objective To investigate the changes of electrocardiogram（ECG） in dual pathway conduction of atrioventricular node（AVN） revealed by dynamic electrocardiogram（DCG）. Methods The ECG characteristics and special ECG phenomena of 11 patients with dual atrioventricular node pathway diagnosed by dynamic ECG were retrospectively analyzed. Results In all the 11 patients, PR interval jumping prolongation occurred in dynamic electrocardiogram, and 4 of them showed two characteristic ECG phenomena which revealed the existence of dual atrioventricular node pathways.（1）Premature atrial beats revealed double atrioventricular nodal pathways in 7 cases.There were 6 cases of slow-fast atrioventricular nodal reflex tachycardia（AVNRT） induced by prolonged PR interval of atrial premature beats（two of them had single slow-fast atrioventricular nodal reflex, i.e. atrial echo appeared after prolonged PR interval of atrial premature beats）; atrial premature beats prolonged PR interval of atrial premature beats and lasted several beats. There was one case of downward transmission of pathways（another ECG phenomenon was also present in this case: fixed PR interval of length and spontaneous transition of conduction between fast and slow pathways）;（2） Atypical Ventricular Blockade（AVB）, PR Interval Jumping Extension and PR Interval Jumping Extension followed by slow pathway downward transmission, and slow pathway forward transmission was terminated in1 case by blocked downward P wave;（3） Atypical ventricular block with Wenckebach cycle, and there was one patient’s Wenckebach cycle ended with an atrial echo;（4）Second degree 2:1 atrioventricular block, two fixed PR intervals between long and short phases, fast-slow pathway conduction after downward blocked P-wave in 1 case;（5）The PR interval jumping type was prolonged excessively after the insertion of premature ventricular beats, and the phenomenon of slow pathway downward transmission was associated with atypical antiventricular conduction in 1 case. Conclusions Jumping prolongation of PR interval is an indispensable feature of dual atrioventricular nodal pathways. Understanding these characteristic ECG phenomena is helpful to diagnose dual atrioventricular nodal pathway conduction by surface ECG and reduce misdiagnosis.关键词：Dual atrioventricular node pathways;Atrioventricular node reentrant tachycardia;Linking phenomenon;Wenckebach’s phenomenon;dynamic electrocardiogram2|21|0更新时间：2025-10-15
- 摘要：Objective To study the effect of echocardiography on cardiac resynchronization therapy（CRT） in patients with heart failure. Methods From January 2018 to January 2020, 18 patients with heart failure who received CRT treatment in our hospital were selected. All patients underwent AV and VV interval optimization after surgery,and summarized the heart failure changes in functional indicators and cardiac synchronization indicators before and after surgery. Results One week after operation, there was no significant difference between the patient’s cardiac function and cardiac synchronization indicators compared with the preoperative index（p<0.05）, but the patients’ LVDD, LVDS, LVEDV and LVESV were compared with those at 3 and 6 months after operation. The preoperative comparison was significantly lower, while the 6 MHW and LVEF were significantly higher than preoperative（p<0.05）,and the postoperative cardiac synchronization indexes were significantly better than preoperative（p<0.05）.Conclusions The use of echocardiography to optimize the AV and VV intervals of patients with heart failure after surgery can improve the effect of cardiac resynchronization therapy, and effectively improve the patients’ biventricular synchronization and cardiac function. It is worthy of promotion.关键词：Echocardiography;Cardiac resynchronization;heart failure;Efficacy evaluation0|13|0更新时间：2025-10-15
- 摘要：Objective To investigate the correlation of 24-hour average heart rate with carotid atherosclerosis in patients with initial hypertension. Methods A total of 368 initial hypertension outpatients were selected from January2018 to February 2019. All patients were monitored by 24-hour ambulatory blood pressure monitoring and holter monitor. According to the carotid atherosclerosis, the patients were divided into IMT≥1.0 mm group（n=179）, and IMT<1.0 mm group（n=189）. The biochemical indexes and blood pressure parameters of the two groups were compared. The correlation between 24-hour average heart rate and IMT was analyzed. Results Patients with IMT≥1.0 mm group had lower HDL-C and higher 24-hour average heart rate, IMT than those in the group with IMT<1.0 mm.The 24-hour average heart rate was correlated with the IMT（r=0.337, p=0.021）. Multiple Logistic analysis showed that HDL-C（OR=0.067, 95%CL, 0.005-0.90, p=0.042） and 24-hour average heart rate（≥75 bpm）（OR=1.13, 95%CL, 1.005-01.271, p=0.041） were correlated with IMT（all p<0.01）. Conclusions The 24-hour average heart rate has correlated with carotid atherosclerosis in patients with initial hypertension.关键词：Initial hypertension;Heart rate;Carotid atherosclerosis2|17|0更新时间：2025-10-15
- 摘要：Objective To investigate the effects of exercise treadmill training combined with moderate resistance exercise on cardiac function and exercise endurance in elderly heart failure patients with left ventricular ejection fraction retention. Methods One hundred and twenty-seven elderly heart failure patients with left ventricular ejection fraction retention who visited our hospital from January 2018 to July 2019 were selected as study subjects and divided into control group（n=63） and observation group（n=64） according to the random number table method. The control group was given exercise treadmill training, and the observation group was given resistance exercise training on the basis of the control group. After 3 months, the improvement effect of cardiac function, cardiac function and exercise endurance of patients in the two groups were compared. Results After intervention, the cardiac function grading of New York Heart Disease Assocation（NYHA） in the observation group was better than that in the control group（p <0.05）. The observed group of Left ventricular end systolic diameter（LVSD） and Left ventricular end Diastolic diameter（LVDD） were lower than the control group（p<0.05）,and the Left Ventricular Ejection Fraction（LVEF）. LVEF, 6 min walking distance, Peak Power（PP）, and Exercise duration（ED） in the observation group were higher than those in the control group（p <0.05）. Conclusions Exercise treadmill training combined with moderate resistance exercise can effectively improve the exercise endurance of elderly heart failure patients with left ventricular ejection fraction retention by improving their cardiac function grade and cardiac function indicators.关键词：Exercise training;Resistance exercise;Left ventricular ejection fraction retention;heart failure;Exercise endurance2|18|0更新时间：2025-10-15
- 摘要：Objective To evaluate the clinical value of emergency bedside ultrasound combined with Point-of-care testing in patients with acute myocardial infarction. Methods A total of 120 patients with acute myocardial infarction admitted to Dongguan Huangjiang Hospital from January 2019 to October 2020 were randomly divided into three groups. The 3 groups were bedside echocardiography group（EB-Echo group）, emergency bedside ultrasound combined with POCT Group（EB-Echo+POCT group）, and POCT group, there were 40 cases in each group. Patients in the EB-Echo group and EB-Echo+POCT group were examined by bedside echocardiography. The venous blood of the patients in the EB-Echo+POCT group and the POCT group was collected, and the level of myocardial markers CK-MB, c Tnl and Myo were detected by the POCT detector. Compare the diagnostic coincidence rate, inspection response time, inspection time and diagnosis time of each group. Results The positive coincidence rate, negative coincidence rate and total coincidence rate of the EB-Echo+POCT group were all 100%, which were higher than those of the EB-Echo group（total coincidence rate of 93.5%） and POCT group（total coincidence rate of98.6%）. The POCT group’s positive coincidence rate, negative coincidence rate and total coincidence rate（98.2%,100%, 98.6%） were higher than EB-Echo（90.1%, 97.5%, 93.5%）. The examination reaction time of the EB-Echo group was（12.1±3.8） min, the examination time was（7.8±2.2） min, and the diagnosis time was（6.3±1.4） min; the examination reaction time of the EB-Echo+POCT group was（13.9± 3.5） min, inspection time was（7.9±2.0） min,diagnosis time was（4.8±1.2） min. The reaction time of POCT was（15.0±3.1） min, the time for inspection was（10.4±2.4） min, and the time for diagnosis was（7.1±1.6） min. Comparing the three groups with each other, there was no statistically significant difference in the examination reaction time, examination time, and diagnosis time（t values were 1.659, 1.809, and 1.735, p>0.05）. Conclusions Emergency bedside ultrasound combined with POCT can reach a diagnosis rate of 100% in patients with acute myocardial infarction, and the sensitivity is better than pure bedside ultrasound and POCT technology. It is worthy of clinical promotion.关键词：Emergency bedside ultrasound;Point-Of-Care testing;Acute myocardial infarction;Clinical value2|18|0更新时间：2025-10-15
- 摘要：Objective To study the effects of health education and exercise rehabilitation based on Information-Motivation-Behavioral model（IMB） on the level of information, confidence and behavior and cardiac function of elderly patients with coronary artery disease（CAD） after PCI. Methods One hundred and twenty-five elderly patients with coronary heart disease after PCI admitted to our hospital from June 2018 to June 2019 were selected and divided into control group（n=62） and study group（n=63） according to the random number table method. The control group was given resistance training combined with 10,000 steps walking training, and the study group added health education based on IMB model on the basis of the control group. Observation and follow-up for 6 months after the two groups of patients to know the level of faith, cardiac function indicators.Results The scores of health knowledge, health beliefs and health behaviors in the study group were significantly higher than those in the control group（p<0.05）. The Left ventricular end diastolic diameter（LVEDD） and Left ventricular end systolic diameter（LVESD） in the study group were significantly lower than those in the control group（p<0.05）. Left Ventricular Ejection fraction（LVEF） and 6 min walk distance（6-min walk test, 6 MWT） were significantly higher than that of the control group（p <0.05）. Conclusions Health education and exercise rehabilitation based on IMB model can significantly improve the level of knowledge, trust and practice of elderly patients with coronary heart disease after PCI, promote physiological remodeling of myocardial structure, improve cardiac function indicators of patients, and can be promoted clinically.关键词：Health education;Rehabilitation;Elderly;coronary heart disease2|12|0更新时间：2025-10-15
- 摘要：Objective To investigate the characteristics and the clinical significance of atypical ventricular pre-excitation electrocardiogram（ECG）. Methods We chose 28 cases of atypical ventricular pre-excitation in the physical examination center of our hospital from June 2018 to October 2020. In the 28 patients, transit absent of the ventricular pre-excitation was found in 10 cases, and normal ECG had been recorded in each year’s physical examination. Results We analyzed the ECG of 28 cases of atypical ventricular pre-excitation and compared them to10 cases with normal ECG. The PR interval of atypical ventricular pre-excitation was more than 0.10 s. The average QRS duration was about 0.12 s. The Q wave was absent in leads Ⅱ, Ⅲ, a VF and V4-V6, and the QRS wave widened slightly with an average duration of 0.11 s. The ventricular pre-excitation had almost no effect on the slope of the ascending branch of R wave, but little effect on the ST-T segment except the initial part of QRS complex.Conclusions Through the analysis of atypical ventricular pre-excitation, the QRS waveform has certain characteristics, and the comprehensive analysis can improve the diagnosis of bypass, which has certain clinical significance.关键词：Atypical;Ventricular pre-excitation;Electrocardiogram0|12|0更新时间：2025-10-15
- 摘要：<正>由王福军教授等编著、崔炜和李广平教授作序推荐的《心血管内科查房思维》一书,已于近日由中南大学出版社出版发行。本书在编写过程中作了一种新的尝试,突出"查"字,力求反映查房的思维过程。将临床日常工作系统化、结构化,将纷繁的住院诊疗工作分解为"入院评估""病情分析""诊疗计划""病程观察""住院小结"五个环节,突出了基本功在查房时的重要作用和价值,特别适合心血管初级医生的参考书,也可作为心内科轮转医生的案头书和口袋书。0|7|0更新时间：2025-10-15
- 摘要：<正>患者,男性,44岁。因"反复心悸10余年"入院。患者10余年前无明显诱因出现心悸,无胸闷胸痛,无头晕头痛,无黑曚晕厥等不适。心悸呈突发突止,持续约数分钟后好转。十余年来心悸反复发作,且发作频率逐渐增高,持续时间逐渐延长。现患者每月发作心悸2次左右,每次持续半小时好转。患者就诊于浙江省人民医院门诊,行常规心电图检查示:窦性心律不齐,平均心率60bpm,QRS波形态正常未见心室预激图形（图略）。在门诊行食管心脏电生理检查（图1、图2）,关键词：隐匿性;双旁道;食管法心脏电生理;房室折返性心动过速2|21|0更新时间：2025-10-15
- 摘要：<正>患者女性,63岁。主因"心悸伴乏力10月余,加重伴黑矇1周"入院。心电图示心率54bpm。心脏超声示:二尖瓣+三尖瓣位置换瓣术后;瓣膜功能未见明显异常;双房显著增大;三尖瓣返流（轻度）、主动脉瓣返流（轻度）、肺动脉瓣返流（轻度）、心包积液（微少量）;既往诊断"阵发性房颤;阵发性房扑;慢-快综合征",规律口服胺碘酮和酒石酸美托洛尔。入院1周后行永久起搏器植入术。穿刺左锁骨下静脉,关键词：三尖瓣置换术;生物瓣;心室起搏2|20|0更新时间：2025-10-15
- 摘要：<正>患者女性,61岁。因"胸闷20余日"于2020年4月4日入我院。临床诊断:（1）冠心病;（2）心脏瓣膜病,主动脉瓣重度狭窄伴关闭不全,二尖瓣中度狭窄伴关闭不全;（3）NYHA心功能Ⅲ级。患者于2020年4月13日,接受二尖瓣+主动脉瓣置换术。术中见右房明显扩大,肺动脉增宽,主动脉与肺动脉比1:1.2。主动脉瓣叶增厚,瓣叶钙化挛缩融合,瓣叶交界严重融合,致主动脉重度狭窄。切开右心房及房间隔,探查见左房内无血栓,二尖瓣瓣叶挛缩融合,腱索融合致狭窄并关闭不全,三尖瓣环扩大,关闭不全。手术顺利,术后恢复良好,2020年4月25日出院。关键词：完全性左束支阻滞;反复搏动;心电图2|12|0更新时间：2025-10-15
- 摘要：<正>患者男性,58岁。因"间断心悸6年,再发半小时"入院,每次心悸持续约1h。患者心动过速发作时的心电图提示房室结折返性心动过速（AVNRT）。入院后患者完善相关辅助检查,择期行心腔内电生理检查。心腔内电图示心室刺激VA逆传递减,提示无隐性旁道;冠状窦电极程序刺激可见房室结跃增现象并心房回波（图1）。静滴异丙肾上腺素后,给予S1S2刺激呈现出房室结跃增后诱发AVNRT。发作过程中腔内电图示AV 2:1传导（图2）,关键词：房室结折返性心动过速;心房颤动;射频消融2|14|0更新时间：2025-10-15
- 摘要：<正>患者男性,46岁。因"发作性胸闷胸痛4年,加重2周"为主诉入院。4年前出现活动后心前区疼痛,为压榨样,伴有胸闷,每次持续5-10min,休息或含服硝酸梨酯片缓解。曾行冠脉造影检查,自述血管狭窄60%（具体不祥）,未治疗。近2周,患者上述症状发作频繁入住我科进一步治疗。患者入院后体格检查及相关检查无异常,静息心电图未见明显异常（图1）。给予患者冠心病二级药物应用,待择期冠脉造影检查。入院后第1天夜间凌晨2:50,患者突发剧烈胸骨后疼痛,伴大汗,持续约2min后突发意识丧失,心音脉搏消失,呈濒死叹气样呼吸。立即启动抢救。抢救过程中记录心电图出现"巨型R波"改变（图2）。考虑急性心肌缺血梗死超急性期。关键词：巨R波综合征;心电图;急性心肌梗死2|13|0更新时间：2025-10-15
- 摘要：<正>一.下壁导联的De Winter ST-T改变2008年,荷兰医生De Winter等[1]通过回顾分析1532例左前降支近段闭塞急性冠脉综合征患者心电图变化,发现有30例患者未出现典型ST段抬高的心肌梗死超急性期改变,而表现为胸前导联J点压低1-3mm,ST段上斜型压低,随后T波对称高尖,多数患者a VR导联ST段轻度上抬。2009年Verouden等[2]在1890例急性前壁心肌梗死行直接经皮冠状动脉介入的患者中发现35例有该特征的心电图患者,关键词：心电图;心律失常;冠心病;心肌缺血2|16|0更新时间：2025-10-15
- 摘要：<正>儿茶酚胺敏感性室性心动过速（Catecholaminergic Polymorphic Ventricular Tachycardia, CPVT）是一种对儿茶酚胺刺激敏感的遗传性心律失常综合征,特征为肾上腺素能刺激诱导的双向性或多形性室速,发作时表现为晕厥,甚至心脏性死（Sudden Cardiac Death, SCD）[1]。儿茶酚胺敏感性室速在普通人群的发病率约为1/10000。但由于患者不发作时心电图基本正常,心脏影像检查也无结构异常,误诊和漏诊率均较高,导致其发病率难以估计,我国仅有部分病例报道,缺乏发病率的真实数据[1]。儿茶酚胺敏感性室速发病主要见于儿童和青少年,恶性程度高,关键词：儿茶酚胺敏感性室性心动过速;基因突变;运动试验;双向性室性心动过速;β受体阻滞剂2|32|0更新时间：2025-10-15
- 摘要：仰卧位高血压常见于自主神经功能衰竭所致的神经源性直立性低血压患者。仰卧位高血压促进夜间钠排泄,促进直立性低血压的形成,从而影响患者的生活质量。原发性高血压的相关研究以及自主神经功能衰竭相关的小规模研究均表明,仰卧位高血压患者可能更易患心血管疾病和肾脏疾病。上述研究为治疗仰卧位高血压提供了理论依据。然而,仰卧位高血压的治疗,无论是药物或非药物方法,都可能加重夜间起床时的直立性低血压,并可能导致跌倒相关的并发症。目前仍需要更多的研究来确定仰卧位高血压对心血管、脑血管和肾脏疾病发病率和死亡率的有害影响。仰卧位高血压的个体化管理需要整合多项数据,包括更精确的心血管风险评估,治疗效果,安全性,以及造成自主神经功能衰竭的潜在病因的预后。关键词：自主神经功能衰竭;神经疾病;直立性低血压;仰卧位高血压2|33|0更新时间：2025-10-15
- 摘要：<正>[定义] 1961年,Edwin C. Brockenbrough、Eugene Braunwald、Andrew G.Morrow三位学者在Circulation杂志首次报道,应用心导管术测量肥厚型心肌病（HCM）患者左室流出道-主动脉压力阶差,窦性心律时阶差不明显,而早搏长代偿间期后第1跳心搏时阶差显著增加的现象,可用于揭示左室流出道隐匿性梗阻及其程度。人们将上述现象命名为Brockenbrough-Braunwald-Morrow征。[临床及检查特点]（1）临床表现:患者无症状或表现为劳累后发作性呼吸困难,可能在胸骨左缘3-4肋间闻及收缩期喷射样杂音,关键词：肥厚型心肌病;心脏超声;左室流出道梗阻;二尖瓣收缩期前向运动2|18|0更新时间：2025-10-15
- 摘要：<正>左室乳头肌室早/室速是特发性室性心律失常的一种,其与起源于左室其他部位（例如分支、冠状窦口、流出道和二尖瓣环）室早/室速的形态相似,应用体表12导联心电图准确定位相对较困难。最近,Brice觡o等提出的V1单导联定位法,有助于快速识别左室乳头肌室早。[定义]上述方法主要是指无器质性心脏病的患者,室早呈类右束支阻滞图形时,单用V1导联室早QRS波的形态及类本位曲折时限较短等特点,可以初步判定室早起源于左室乳头肌。[心电图表现及诊断标准]关键词：左室乳头肌;室性早搏;室性心动过速;类本位曲折2|28|0更新时间：2025-10-15
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