自发性心绞痛发作期间缺血对QT离散度的影响。

Effects of ischemia on QT dispersion during spontaneous anginal episodes.

作者信息

Dilaveris P, Andrikopuolos G, Metaxas G, Richter D, Avgeropoulou C, Androulakis A, Gialafos E, Michaelides A, Toutouzas P, Gialafos J

机构信息

State and University Department of Cardiology, Hippokration Hospital, Athens, Greece.

出版信息

J Electrocardiol. 1999 Jul;32(3):199-206.

PMID:10465563

Abstract

Myocardial ischemia induced by pacing, angioplasty, or stress results in a significant increase in QT dispersion (QTd = QT maximum - QT minimum). This study investigated the effects of ischemia on QTd and the rate-corrected QTd (QT(c)d) during spontaneous anginal episodes in patients with coronary artery disease (CAD). Ninety-five patients with CAD and typical angina pectoris and 15 control subjects complaining of anginalike symptoms were studied. QTd and QT(c)d were calculated from 12-lead surface electrocardiograms recorded during and after the relief of pain. QTd and QT(c)d were significantly higher during the anginal episode (84+/-31 ms and 98+/-51 ms) compared to the painless conditions (69+/-24 ms and 71+/-24 ms) (P = .003 and P = .001 for QTd and QT(c)d, respectively) only in the 57 CAD patients who had a history of an old previous myocardial infarction. QTd and QT(c)d are significantly increased during spontaneous angina in patients with documented CAD and history of previous myocardial infarction.

摘要

起搏、血管成形术或应激所诱发的心肌缺血会导致QT离散度（QTd = QT最大值 - QT最小值）显著增加。本研究调查了冠状动脉疾病（CAD）患者在自发性心绞痛发作期间缺血对QTd和心率校正QTd（QT(c)d）的影响。对95例患有CAD且有典型心绞痛的患者以及15例主诉有类似心绞痛症状的对照受试者进行了研究。QTd和QT(c)d根据疼痛缓解期间及之后记录的12导联体表心电图计算得出。仅在57例有陈旧性心肌梗死病史的CAD患者中，心绞痛发作期间的QTd和QT(c)d（分别为84±31毫秒和98±51毫秒）显著高于无痛状态时（分别为69±24毫秒和71±24毫秒）（QTd和QT(c)d的P值分别为0.003和0.001）。在有记录的CAD且有既往心肌梗死病史的患者中，自发性心绞痛发作期间QTd和QT(c)d显著增加。