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左心室部分切除术(巴蒂斯塔手术)患者的QT间期离散度分析。

QT interval dispersion analysis in patients undergoing left partial ventriculectomy (Batista operation).

作者信息

Pastore Carlos Alberto, Arcêncio Sandra Regina, Tobias Nancy M M O, Kaiser Elisabeth, Filho Martino Martinelli, Moreira Luis Felipe P, Stolf Noedir A, Bocchi Edimar, Ramires José Antonio Franchini

机构信息

Heart Institute (InCor) of the University of São Paulo Medical School, São Paulo, Brazil.

出版信息

Ann Noninvasive Electrocardiol. 2004 Oct;9(4):375-82. doi: 10.1111/j.1542-474X.2004.94582.x.

Abstract

BACKGROUND

QT interval dispersion (QTd) has been valued as a marker of increased vulnerability for cardiac arrhythmias. QTd was analyzed in patients undergoing the left partial ventriculectomy (LPV) or Batista operation, a palliative surgery for patients in the line for heart transplantation, which is associated with complex arrhythmia and death from sustained ventricular tachyarrhythmia (SVT).

METHODS

Pre- and postoperative R-R, QT, QTc, JT (QT - QRS), and aT (apex to end of T wave) intervals were obtained by 87-lead body surface mapping from 24 patients (18 male), mean age 46.4 +/- 9.15 years. Dispersions of QT, QTc, JT, and aT intervals were calculated, and the total number of arrhythmic events were assessed, aiming to verify a possible risk predictor for the occurrence of SVTs. Subgroups of patients who survived and who died after LPV were also compared, aiming to obtain a QTd cutoff value that could be used prognostically.

RESULTS

No difference between pre- and postoperative mean values were found, but a very significant difference was seen when comparing QTd and QTcD values for surviving and dead patients: QTd, cutoff value was 95 ms, while QTcD value was 114 ms.

CONCLUSION

There were no significant differences between pre- and postoperative variables or the number of arrhythmic events, but there were significant differences between both pre- and postoperative QTd and QTcD data from surviving and dead patients; this enabled the determination of cutoff values that we believe may be useful for the prognosis of the LPV outcome.

摘要

背景

QT间期离散度(QTd)被视为心律失常易感性增加的一个指标。对接受左心室部分切除术(LPV)或巴蒂斯塔手术(一种适用于心脏移植排队患者的姑息性手术,该手术与复杂心律失常及持续性室性心动过速(SVT)导致的死亡相关)的患者进行了QTd分析。

方法

通过87导联体表标测从24例患者(18例男性)获取术前及术后的R-R、QT、QTc、JT(QT - QRS)和aT(T波顶点至终点)间期,患者平均年龄46.4±9.15岁。计算QT、QTc、JT和aT间期的离散度,并评估心律失常事件的总数,旨在验证SVT发生的可能风险预测指标。还比较了LPV术后存活和死亡患者的亚组,旨在获得可用于预后判断的QTd临界值。

结果

术前和术后平均值之间未发现差异,但比较存活和死亡患者的QTd及QTcD值时发现了非常显著的差异:QTd临界值为95毫秒,而QTcD值为114毫秒。

结论

术前和术后变量或心律失常事件数量之间无显著差异,但存活和死亡患者术前及术后QTd和QTcD数据之间存在显著差异;这使得能够确定我们认为可能对LPV手术结果预后有用的临界值。

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