T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with orthostatic hypertension and their clinical significance
ZOU Run-Mei, LI Fang, LIN Ping, XU Yi, WANG Cheng
Department of Pediatric Cardiovasology, Children's Medical Center, Second Xiangya Hospital, Central South University, Changsha 410011, China
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.
ZOU Run-Mei,LI Fang,LIN Ping et al. T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with orthostatic hypertension and their clinical significance[J]. CJCP, 2019, 21(7): 696-700.
ZOU Run-Mei,LI Fang,LIN Ping et al. T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with orthostatic hypertension and their clinical significance[J]. CJCP, 2019, 21(7): 696-700.
Streeten DH, Auchincloss JH Jr, Anderson GH Jr, et al. Orthostatic hypertension. Pathogenetic studies[J]. Hypertension, 1985, 7(2):196-203.
[2]
Nibouche-Hattab WN, Lanasri N, Zeraoulia F, et al. Orthostatic hypertension in normotensive type 2 diabetics:what characteristics?[J]. Ann Cardiol Angeiol (Paris), 2017, 66(3):159-164.
[3]
Bhuachalla BN, McGarrigle CA, O'Leary N, et al. Orthostatic hypertension as a risk factor for age-related macular degeneration:evidence from the Irish longitudinal study on ageing[J]. Exp Gerontol, 2018, 106:80-87.
Wang C, Li Y, Liao Y, et al. 2018 Chinese Pediatric Cardiology Society (CPCS) guideline for diagnosis and treatment of syncope in children and adolescents[J]. Sci Bull, 2018, 63(23):1558-1564.
Koskinen J, Juonala M, Dwyer T, et al. Utility of different blood pressure measurement components in childhood to predict adult carotid intima-media thickness[J]. Hypertension, 2019, 73(2):335-341.
