Sakata K, Shimizu M, Ino H, Yamaguchi M, Terai H, Hayashi K, Kiyama M, Hayashi T, Inoue M, Mabuchi H
Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Heart. 2003 Aug;89(8):882-6. doi: 10.1136/heart.89.8.882.
To evaluate the relation between QT variables and disproportion of left ventricular wall hypertrophy in patients with hypertrophic cardiomyopathy.
Retrospective analysis of the results of echocardiography and electrocardiography.
University hospital (tertiary referral centre).
70 patients with hypertrophic cardiomyopathy were divided into four groups according to the distribution of left ventricular wall hypertrophy on cross sectional echocardiography: group A--hypertrophy confined to the interventricular septum; group B--hypertrophy confined to the interventricular septum and left ventricular anterior wall; group C--hypertrophy confined to the interventricular septum, left ventricular anterior wall, and lateral free wall; group D--hypertrophy involving all portions of the left ventricle.
QT intervals and QT dispersion in precordial six lead ECGs.
There were no significant differences in the maximum left ventricular wall thickness among the four groups, and maximum and minimum QTc intervals also did not differ. QTc dispersion was increased significantly in groups A and B compared with groups C and D. Dispersions of the interval from the J point to the end of the T wave (JTc dispersions) in groups A and B were also increased significantly compared with groups C and D. By linear regression analysis, QTc and JTc dispersions correlated with the ratio of the interventricular septal thickness to left ventricular posterior wall thickness (p = 0.0152 and p = 0.0075, respectively).
QT dispersion may be affected by not only electrical inhomogeneity but also by morphological inhomogeneity of the left ventricle in patients with hypertrophic cardiomyopathy.
评估肥厚型心肌病患者QT变量与左心室壁肥厚不均的关系。
对超声心动图和心电图结果进行回顾性分析。
大学医院（三级转诊中心）。
70例肥厚型心肌病患者根据横断面超声心动图上左心室壁肥厚的分布分为四组：A组——肥厚局限于室间隔；B组——肥厚局限于室间隔和左心室前壁；C组——肥厚局限于室间隔、左心室前壁和外侧游离壁；D组——肥厚累及左心室所有部分。
胸前导联六导联心电图中的QT间期和QT离散度。
四组之间最大左心室壁厚度无显著差异，最大和最小QTc间期也无差异。与C组和D组相比，A组和B组的QTc离散度显著增加。与C组和D组相比，A组和B组从J点到T波终点的间期离散度（JTc离散度）也显著增加。通过线性回归分析，QTc和JTc离散度与室间隔厚度与左心室后壁厚度之比相关（分别为p = 0.0152和p = 0.0075）。
肥厚型心肌病患者的QT离散度可能不仅受电不均一性影响，还受左心室形态不均一性影响。
