12-lead electrocardiogram for orthostatic hypertension in children and its clinical significance / 中国基层医药

ABSTRACT

Objective:To investigate the 12-lead electrocardiogram findings and their clinical significance in children with orthostatic hypertension (OHT), providing evidence for clinical diagnosis and treatment of OTH.Methods:Thirty-four children with OHT who received diagnosis and treatment in the Zhuji Second People's Hospital from January 2017 to December 2019 were included in the OHT group. An additional 34 healthy children who concurrently received routine physical examination were included in the control group. Both groups of children underwent a 12-lead electrocardiogram in lying and standing positions. The changes in ST-segment and T-wave amplitudes in the lying position relative to the standing position were compared between the two groups.Results:The changes in T-wave amplitude of leads II, V 5, and V 6 in the OHT group were (0.07 ± 0.11) mV, (0.13 ± 0.12) mV, and (0.14 ± 0.11) mV, respectively, which were significantly higher than those in the control group [(0.02 ± 0.07) mV, (0.05 ± 0.06) mV, (0.03 ± 0.04) mV, t = 2.24, 3.48, 5.48, P = 0.029, 0.001, < 0.001). There were no significant differences in the changes in T-wave amplitude of other leads between the two groups (all P > 0.05). There was no significant difference in change in ST-segment amplitude on 12-lead electrocardiogram images between the two groups (all P > 0.05). The area under the curve of the changes in T-wave amplitude of leads II and V 5 in predicting OHT in children was 0.596 and 0.672 respectively, the sensitivity was 64.71% and 55.88%, respectively, and the specificity was 70.59% and 61.76%, respectively. The changes in T-wave amplitude of leads II and V 5 had low efficacy in predicting OHT in children. The area under the curve of the change in T-wave amplitude of lead V 6 in predicting OHT in children was 0.738, and the sensitivity and specificity were 76.47% and 67.65%, respectively. The change in T-wave amplitude of lead V 6 had moderate efficacy for predicting OHT in children. Conclusion:The changes in T-wave amplitude of lead V 6 on the electrocardiogram image taken in the lying position relative to the standing position are of certain value in predicting OHT in children. The 12-lead electrocardiogram can provide important evidence for clinical prediction and diagnosis of OHT in children.