Darbar D, Cherry C J, Kerins D M
Department of Medicine, Vanderbilt University and Veterans Administration Medical Center, Nashville, Tennessee, USA.
Heart. 1999 Jul;82(1):15-8. doi: 10.1136/hrt.82.1.15.
To investigate whether QT dispersion is a reliable index of the severity of aortic stenosis and left ventricular hypertrophy in the setting of aortic stenosis.
A retrospective analysis of the results of echocardiography and electrocardiography before and after aortic valve replacement.
Tertiary centre.
36 men (30 white and six black) with symptomatic aortic stenosis requiring valve replacement.
All patients had significant aortic stenosis (mean (SD) aortic valve area 0.68 (0.18) cm2) and evidence of left ventricular hypertrophy (left ventricular mass index (LVMI): 267 (90) g/m2). Before aortic valve replacement, QT dispersion was correlated with mean aortic valve area and LVMI (r = 0.697, p < 0.001, and r = 0.59, p < 2.4 x 10(-6), respectively). QT dispersion and QT corrected for heart rate dispersion decreased from 133 (54) to 71 (33) ms and from 151 (64) to 94 (76) ms, respectively (p < 0.001 for both). LVMI regressed after aortic valve replacement to 190 (79) g/m2, p < 0.01.
QT dispersion is increased in association with LVMI in patients with significant symptomatic aortic stenosis. Aortic valve replacement reduces QT dispersion and LVMI. QT dispersion could be a useful indicator of risk and risk reduction in patients with significant symptomatic aortic stenosis.
探讨在主动脉瓣狭窄情况下，QT离散度是否是反映主动脉瓣狭窄严重程度及左心室肥厚的可靠指标。
对主动脉瓣置换术前、后的超声心动图和心电图结果进行回顾性分析。
三级医疗中心。
36例有症状的主动脉瓣狭窄且需要进行瓣膜置换的男性患者（30例白人，6例黑人）。
所有患者均有明显的主动脉瓣狭窄（平均（标准差）主动脉瓣面积为0.68（0.18）cm²）及左心室肥厚证据（左心室质量指数（LVMI）：267（90）g/m²）。在主动脉瓣置换术前，QT离散度与平均主动脉瓣面积及LVMI相关（相关系数分别为r = 0.697，p < 0.001；r = 0.59，p < 2.4×10⁻⁶）。QT离散度及校正心率后的QT离散度分别从133（54）ms降至71（33）ms，从151（64）ms降至94（76）ms（两者p均< 0.001）。主动脉瓣置换术后LVMI降至190（79）g/m²，p < 0.01。
有症状的严重主动脉瓣狭窄患者的QT离散度随LVMI升高。主动脉瓣置换可降低QT离散度及LVMI。QT离散度可能是有症状的严重主动脉瓣狭窄患者风险及风险降低的有用指标。
