急性心肌梗死介入治疗后ST段分辨率对QT离散度的影响。

The effect of ST resolution on QT dispersion after interventional treatment in acute myocardial infarction.

作者信息

Ilkay Erdoğan, Yavuzkir Mustafa, Karaca Ilgin, Akbulut Mehmet, Pekdemir Murat, Aslan Nadi

机构信息

Department of Cardiology, Firat University, School of Medicine, Elaziğ, Turkey.

出版信息

Clin Cardiol. 2004 Mar;27(3):159-62. doi: 10.1002/clc.4960270313.

DOI:10.1002/clc.4960270313

PMID:15049385

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6654344/

Abstract

BACKGROUND

It has been reported that reperfusion treatment reduces QT dispersion (QTD) in cases of acute myocardial infarction (AMI). Successful myocardial perfusion is not synonymous with Thrombolysis in Myocardial Infarction (TIMI) III flow. It has been demonstrated that in AMI, the grade of ST-resolution correlates strongly with left ventricular (LV) function, enzyme elevation, and mortality after primary angioplasty.

HYPOTHESIS

This study investigated the relation between ST-resolution grade and QTD and the feasibility of using QTD as a determinant of successful myocardial tissue perfusion in patients in whom TIMI III flow in the infarct-related artery (IRA) is restored by interventional treatment for AMI.

METHODS

The study included 57 patients (38 men, 19 women, average age 54.4 +/- 11.6 years), whose IRA was perfused by primary angioplasty after the diagnosis of anterior AMI with ST elevation. Electrocardiograms of patients were taken 45 +/- 12 min post procedure, and patients were divided into three groups depending on the grade of ST resolution: Group 1, full ST resolution; Group 2, partial ST resolution; and Group 3, unsuccessful ST resolution.

RESULTS

Full ST resolution was seen in 19 cases (33%), partial resolution in 26 cases (47%), and unsuccessful resolution in 12 cases (20%). There were no differences among groups in terms of risk factors, stent diameters, symptom onset-balloon time, LV function, and preprocedure corrected QTD (QTcD) (p = 0.274). After the procedure, a significant reduction in QTcD was found within the groups (p = 0.0001 in Group 1, p = 0.004 in Group 2, and p = 0.011 in Group 3). Reductions in QTcD post procedure were 24.21 +/- 14.27, 11.85 +/- 16.18, and 12.50 +/- 11.58 ms in Groups 1, 2, and 3, respectively. There was a statistically significant difference of p = 0.015 between Groups 1 and 2 and a difference of p = 0.028 between Groups 1 and 3. There was no statistically significant difference between Groups 2 and 3 (p = 0.916).

CONCLUSION

In acute MI, TIMI III flow led to a reduction in QTcD, and full myocardial perfusion made an additional contribution to the electrical stability of the myocardium.

摘要

背景

据报道，再灌注治疗可降低急性心肌梗死（AMI）患者的QT离散度（QTD）。成功的心肌灌注并非等同于心肌梗死溶栓治疗（TIMI）3级血流。已经证明，在AMI中，ST段回落程度与左心室（LV）功能、酶升高以及直接血管成形术后的死亡率密切相关。

假设

本研究调查了ST段回落程度与QTD之间的关系，以及在通过AMI介入治疗使梗死相关动脉（IRA）达到TIMI 3级血流的患者中，使用QTD作为心肌组织灌注成功的决定因素的可行性。

方法

本研究纳入了57例患者（38例男性，19例女性，平均年龄54.4±11.6岁），这些患者在诊断为ST段抬高型前壁AMI后接受了直接血管成形术，IRA得以灌注。术后45±12分钟记录患者的心电图，并根据ST段回落程度将患者分为三组：第1组，ST段完全回落；第2组，ST段部分回落；第3组，ST段回落未成功。

结果

19例（33%）患者ST段完全回落，26例（47%）患者部分回落，12例（20%）患者回落未成功。在危险因素、支架直径、症状发作至球囊扩张时间、LV功能和术前校正QTD（QTcD）方面，各组之间无差异（p = 0.274）。术后，各组内QTcD均显著降低（第1组p = 0.0001，第2组p = 0.004，第3组p = 0.011）。术后第1组、第2组和第3组QTcD的降低值分别为24.21±14.27、11.85±16.18和12.50±11.58毫秒。第1组和第2组之间的p值为0.015，具有统计学显著差异；第1组和第3组之间的p值为0.028。第2组和第3组之间无统计学显著差异（p = 0.916）。