Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 37(3): 203-207 (2021)
doi:10.9794/jspccs.37.203

原著Original

傍膜様部心室中隔欠損症の生後1か月時点での標準12誘導心電図による予後予測Prognosis Prediction for Perimembranous Ventricular Septal Defect Based on 12-Lead Electrocardiograms Obtained a Month after Birth

富山県立中央病院小児科Department of Pediatrics, Toyama Prefectural Central Hospital ◇ Toyama, Japan

受付日:2020年12月8日Received: December 8, 2020
受理日:2021年4月4日Accepted: April 4, 2021
発行日:2021年11月1日Published: November 1, 2021
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目的:perimembranous VSD症例の生後1か月時点における標準12誘導心電図による予後予測の有用性を明らかにすること.

対象と方法:生後1か月時点で標準12誘導心電図が施行され,1歳時に経過観察を受けたperimembranous VSD 44例を対象として,自然閉鎖群(C群)14例,未閉鎖群(U群)17例,手術群(O群)13例の3群に分類し,心電図所見を比較検討した.また,O群対非O群(C群+ U群),C群対非C群(O群+ U群)により手術および自然閉鎖の予測因子も検討した.

結果:結果は(C群vs. U群vs. O群,p値)と記載する.3群の比較ではO群でV1の陽性T波(0% vs. 11.8% vs. 84.6%,p<0.001)が有意に多く,V5のR波が有意に高かった(1.81 (0.72–2.88) mV vs. 2.07 (0.90–3.77) mV vs. 2.34 (1.55–3.85) mV, p=0.027).O群と非O群の比較ではV1の陽性T波が有意に多く(84.6% vs. 6.5%,p<0.001),V1のR波は有意に高かった(1.64 (0.60–4.73) mV vs. 1.21 (0.29–2.62) mV, p=0.015).一方,非C群とC群の比較ではV1の陽性T波が有意に少なく(0% vs. 43.3%,p=0.003),V5のR波(1.81 (0.72–2.88) mV vs. 2.13 (0.90–3.85) mV, p=0.025)とS波(0.61 (0.35–1.55) mV vs. 0.99 (0.26–2.98) mV, p=0.036)は有意に低かった.

結論:perimembranous VSD症例の生後1か月時点における標準12誘導心電図は予後予測に有用であることが示唆された.

Objective: To investigate whether 12-lead electrocardiography at 1 month after birth can predict the prognosis of patients with perimembranous ventricular septal defect (VSD).

Methods: We divided 44 perimembranous VSD cases were divided into three groups according to the outcome at the age of 1 year as follows: naturally closed (n=14), unclosed (n=17), operative (n=13) and compared their electrocardiographic findings with those at the age of 1 month. We also compared the operative group with the nonoperative groups (naturally closed and unclosed) and the naturally closed group with the non-naturally closed groups (operative and unclosed) to identify factors predictive of operation and natural closure, respectively.

Results: The results are shown by (naturally closed vs. unclosed vs. operative; p value). By comparing all the groups, we found that V1 positive T-wave (0% vs. 11.8% vs. 84.6%; p<0.001) was significantly more frequent and the the frequency of the V5 R-wave (1.81 mV [0.72–2.88 mV] vs. 2.07 mV [0.90–3.77 mV] vs. 2.34 mV [1.55–3.85 mV]; p=0.005) was significantly higher in the operative group. V1-positive T-wave (84.6% vs. 6.5%; p<0.001) was significantly more frequent and V1 R-wave (1.64 mV [0.60–4.73 mV] vs. 1.21 mV [0.29–2.62 mV]; p=0.015) was significantly higher in the operative group than in the nonoperative group. In the naturally closed group, the V5 R-wave (1.81 mV [0.72–2.88 mV] vs. 2.13 mV [0.90–3.85 mV]; p=0.025) and V5 S-wave (0.61 mV [0.35–1.55 mV] vs. 0.99 mV [0.26–2.98 mV]; p=0.036) were significantly lower.

Conclusion: In patients with perimembranous VSD, 12-lead electrocardiography at 1 month of age may predict the prognosis at 1 year of age.

Key words: ventricular septal defect; 12 lead electrocardiogram; infant

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This page was last modified on 2021-12-17T11:04:09.000+09:00


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