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  • Title: [T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with orthostatic hypertension and their clinical significance].
    Author: Zou RM, Li F, Lin P, Xu Y, Wang C.
    Journal: Zhongguo Dang Dai Er Ke Za Zhi; 2019 Jul; 21(7):696-700. PubMed ID: 31315771.
    Abstract:
    OBJECTIVE: To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with orthostatic hypertension (OHT) and to determine their clinical significance. METHODS: A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS: In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in leads V4 and V5 were significantly higher in standing ECG than in supine ECG (P<0.05). In the OHT group, T wave amplitude in leads II, aVR, aVF, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in lead II was significantly higher in standing ECG than in supine ECG (P<0.05). The differences in T wave amplitude in lead II and V6 between supine and standing ECG were significantly higher in the OHT group than in the control group (P<0.05). Difference in T wave amplitude in lead V6 between supine and standing ECG was a significant diagnostic marker for OHT (P<0.05). This marker had 72.10% sensitivity and 57.10% specificity for the diagnosis of OHT at the optimal cut-off value of 0.105 mV. CONCLUSIONS: Difference in T wave amplitude in lead V6 between supine and standing ECG has certain diagnostic value for OHT. 目的: 探讨直立性高血压（OHT）儿童卧位与立位心电图T波和ST段振幅变化及其临床意义。 方法: 选取确诊为OHT患儿49例为OHT组，同期按年龄与性别匹配43例健康儿童为对照组。测量两组卧位与立位12导联心电图心率、各导联T波和ST段振幅，比较同组卧位和立位T波振幅、ST段振幅，并比较两组卧位、立位T波振幅差和ST段振幅差。 结果: 对照组aVR、V1、V4~V6导联T波振幅立位较卧位降低（P < 0.05），V4、V5导联ST段振幅立位较卧位增加（P < 0.05）。OHT组Ⅱ、aVR、aVF、V4~V6导联T波振幅立位较卧位降低（P < 0.05），Ⅱ导联ST段振幅立位较卧位增加（P < 0.05）。OHT组Ⅱ、V6导联立位、卧位T波振幅差较对照组增大（均P < 0.05）。V6导联卧位、立位T波振幅差对OHT有诊断价值（P < 0.05），V6导联T波振幅差最佳截断值为0.105 mV，灵敏度为72.10%，特异度为57.10%。 结论: V6导联卧位、立位T波振幅差对OHT儿童具有一定的诊断价值。
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