CORE--AMBULATORY ELECTROCARDIOGRAMS

核心——动态心电图

• 批准号: 6660955
• 负责人: Peter Howard Stone
• 金额: $ 19.62万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-01 至 2003-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6660955
• 关键词: air pollution; arrhythmia; atrial fibrillation; biomedical facility; clinical research; computer program /software; data collection methodology /evaluation; disease /disorder proneness /risk; electrocardiography; heart rate; human data; outpatient care

The main responsibility for the Ambulatory ECG Core is to provide analytical support for other projects which are designed to assess the impact of air pollution on vulnerability to cardiac arrhythmias. The ECG will be assessed both in terms of conventional endpoints including heart rhythm and ST-segment and QRST morphology, and for autonomic tone and cardiac vulnerability. The latter will be determined using the spectral analytical techniques of heart rate variability (HRV) and T-wave alternans, respectively. In the case of Project #1, the analyses will be directed to measuring the effects of air pollution on patients with documented myocardial infarction initially, and for subsequent groups as required. For Project 2, the Core will be a resource of expertise in cardiology. For Project 3, the analyses will provide information concerning the effect of air pollution on the free-living elderly. HRV provides a measure of autonomic balance, an important factor influencing cardiac vulnerability and a possible mediator of the deleterious influences of air pollution. T-wave alternans is a beat-by-beat variation in the area and morphology of that waveform and has been shown in numerous experimental studies to be predictive of ventricular fibrillation during diverse physiologic and pharmacologic interventions. HRV and T- wave alternans have been shown in clinical investigations to be valuable in risk stratification in diverse forms of cardiac disease. Ambulatory BCO data will be analyzed with a high capacity, state-of-the-art MARS Unity Workstation, which runs validated software for all of the standard ECG endpoints and for HRV analysis in time and frequency domains. We have recently developed and validated the software for complex demodulation of the T-wave to quantify the level of alternans and have employed the method in records of ambulatory patients with angina and silent ischemia. Thus, with the availability of this system and the involvement of individuals who are highly experienced in its use, it will -be possible to process and analyze sizeable numbers of ECG data which will be generated by Projects l & 3. Ultimately, this comprehensive hypothesis- directed approach to ECG analysis should provide important insights regarding the effects of air pollution on cardiac vulnerability and should help to elucidate the underlying mechanisms.

门诊心电图核心的主要责任是为旨在评估空气污染对心律不齐的脆弱性的影响的其他项目提供分析支持。 ECG将通过传统的终点来评估，包括心律和ST段和QRST形态，以及自主语调和心脏脆弱性。后者将分别使用心率变异性（HRV）和T-Wave替代品的光谱分析技术确定。在项目＃1的情况下，分析将用于测量空气污染最初对心肌梗塞记录的患者的影响，并根据需要进行随后的组。对于项目2，核心将是心脏病学专业知识的资源。对于项目3，分析将提供有关空气污染对自由生活老年人的影响的信息。 HRV提供了一种衡量自主平衡的量度，这是影响心脏脆弱性的重要因素，也是空气污染影响有害影响的可能的介体。 T-Wave替代品是该波形的区域和形态的逐个差异，并且在许多实验研究中已显示出在不同的生理和药理学干预期间可以预测心室纤维化。在临床研究中，HRV和T-WAVE替代方在各种形式的心脏病中具有有价值的风险分层。 门诊BCO数据将通过高容量，最先进的MARS Unity Workstation进行分析，该工作站运行了所有标准ECG终点的验证软件以及时间和频域中的HRV分析。我们最近开发并验证了T-Wave复杂解调的软件，以量化替代品的水平，并在心绞痛和无声缺血的门诊患者的记录中采用了该方法。因此，随着该系统的可用性以及在其使用方面经验丰富的个人的参与，它将有可能处理和分析项目L＆3项目将产生的大量ECG数据。最终，这种全面的假设指导的ECG分析方法应提供有关对气体脆弱性效果的重要见解，这有助于对无能为力的效果，并有助于熟练的机制。