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单支冠状动脉疾病中的QT离散度:QT离散度与病变冠状动脉或病变部位之间存在关联吗?

QT dispersion in single coronary artery disease: is there a relation between QT dispersion and diseased coronary artery or lesion localization?

作者信息

Tikiz H, Terzi T, Balbay Y, Demir A D, Soylu M, Keles T, Kutuk E

机构信息

Department of Cardiology at Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey.

出版信息

Angiology. 2001 Jan;52(1):43-51. doi: 10.1177/000331970105200106.

Abstract

It has been shown that QT dispersion (QTD) increases during episodes of myocardial ischemia or infarction. However, no extensive data on the relation between the diseased coronary artery or the localization of stenosis and the QTD are available. The aim of the study was to examine the relation between QTD and diseased coronary artery and lesion localization during exercise stress test in patients with single coronary artery disease without prior myocardial infarction. One hundred nineteen patients with single coronary artery disease and 53 patients with normal coronary arteries were enrolled in study. All patients underwent exercise stress test with modified Bruce protocol, and QT interval parameters were measured at rest and at minute 2 of the recovery (rec-2) period. QT dispersion at rest was found higher in all single-vessel disease groups compared with that in the control group, and corrected QT dispersion at rec-2 period was also markedly higher in left anterior descending, circumflex, and right coronary artery groups compared with that in the control group. No relation was found between QT dispersion and diseased coronary artery or the lesion localization. In conclusion, no qualitative difference was found between QT dispersion and diseased coronary artery or proximal or distal lesion localization. However, it was observed that patients with single-vessel disease had wider baseline QT dispersion as compared with that in the control group, which further increased significantly with exercise. This finding supports the idea that severity of localized ischemia rather than extent of coronary artery disease would be expected to have a greater effect on inducible QT dispersion.

摘要

研究表明,心肌缺血或梗死发作期间QT离散度(QTD)会增加。然而,关于病变冠状动脉或狭窄部位与QTD之间关系的广泛数据尚不可得。本研究的目的是在无既往心肌梗死的单支冠状动脉疾病患者运动负荷试验期间,研究QTD与病变冠状动脉及病变部位之间的关系。119名单支冠状动脉疾病患者和53名冠状动脉正常的患者纳入研究。所有患者均采用改良Bruce方案进行运动负荷试验,并在静息时和恢复(rec-2)期第2分钟测量QT间期参数。发现所有单支血管疾病组静息时的QT离散度均高于对照组,左前降支、回旋支和右冠状动脉组在rec-2期的校正QT离散度也显著高于对照组。未发现QT离散度与病变冠状动脉或病变部位之间存在关联。总之,在QT离散度与病变冠状动脉或近端或远端病变部位之间未发现质性差异。然而,观察到单支血管疾病患者的基线QT离散度比对照组更宽,运动后进一步显著增加。这一发现支持了这样一种观点,即局部缺血的严重程度而非冠状动脉疾病的范围预计对诱导性QT离散度有更大影响。

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