心脏交感神经支配对长QT综合征患者局部室壁运动异常的影响。

Effects of cardiac sympathetic innervation on regional wall motion abnormality in patients with long QT syndrome.

作者信息

Yamanari H, Nakayama K, Morita H, Miyazi K, Fukushima K, Matsubara H, Emori T, Ohe T

机构信息

Department of Cardiovascular Medicine, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.

出版信息

Heart. 2000 Mar;83(3):295-300. doi: 10.1136/heart.83.3.295.

DOI:10.1136/heart.83.3.295

PMID:10677409

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1729335/

Abstract

AIM

To assess the spatial relation between regional cardiac sympathetic innervation and regional ventricular repolarisation indicated by ventricular wall motion abnormality in patients with congenital long QT syndrome.

DESIGN

Regional percentage uptake and washout rate of (123)I metaiodobenzylguanidine (MIBG) were measured to assess cardiac sympathetic innervation in septum, anterior wall, lateral wall, and posterior wall. Left ventricular short axis images on echocardiography were digitised to reconstruct digitised M mode echocardiograms, from which left ventricular wall thickness curves were obtained. The wall thickening time (ThT) was defined as the period in which the instantaneous wall thickness exceeded 90% of the maximum wall thickness. The ThT was measured from the ventricular wall thickness curve at the same segments where regional percentage uptake and washout rate of (123)I MIBG were measured.

PATIENTS

Seven patients with long QT syndrome.

RESULTS

The regional washout rate (mean (SD)) of (123)I MIBG in patients with long QT syndrome was greater in the segments with decreased percentage uptake of (123)I MIBG than in those without (17.4 (10.6)% v 9.7 (16.5)%, p < 0. 03). ThT in segments both with and without decreased percentage uptake of (123)I MIBG was longer than in control subjects (p < 0. 0001). ThT was longer in the segments with decreased percentage uptake of (123)I MIBG than in those without (199 (70) ms v 150 (66) ms, p = 0.0018).

CONCLUSIONS

Activation of regional cardiac sympathetic terminals is likely to participate in additional regional prolongation of ventricular repolarisation in patients with long QT syndrome.

摘要

目的

评估先天性长QT综合征患者区域心脏交感神经支配与由室壁运动异常所提示的区域心室复极之间的空间关系。

设计

测量（123）I间碘苄胍（MIBG）的区域摄取百分比和洗脱率，以评估室间隔、前壁、侧壁和后壁的心脏交感神经支配。对超声心动图上的左心室短轴图像进行数字化处理，以重建数字化M型超声心动图，从中获取左心室壁厚度曲线。壁增厚时间（ThT）定义为瞬时壁厚度超过最大壁厚度90%的时间段。ThT是在测量（123）I MIBG区域摄取百分比和洗脱率的相同节段，从心室壁厚度曲线测量得到的。

患者

7例长QT综合征患者。

结果

长QT综合征患者中，（123）I MIBG摄取百分比降低的节段，其（123）I MIBG的区域洗脱率（均值（标准差））高于未降低的节段（17.4（10.6）%对9.7（16.5）%，p<0.03）。（123）I MIBG摄取百分比降低和未降低的节段，其ThT均长于对照组（p<0.0001）。（123）I MIBG摄取百分比降低的节段，其ThT长于未降低的节段（199（70）毫秒对150（66）毫秒，p = 0.0018）。