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特纳综合征女孩的校正心率QT间期延长及其他心电图异常

Prolonged rate-corrected QT interval and other electrocardiogram abnormalities in girls with Turner syndrome.

作者信息

Bondy Carolyn A, Ceniceros Irene, Van Phillip L, Bakalov Vladimir K, Rosing Douglas R

机构信息

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, NIH, Building 10 CRC, Room 1-3330, Bethesda, MD 20892-1103, USA.

出版信息

Pediatrics. 2006 Oct;118(4):e1220-5. doi: 10.1542/peds.2006-0776.

Abstract

BACKGROUND

We recently reported that electrocardiographic abnormalities are common in adults with monosomy X (Turner syndrome), but this issue has not been investigated in girls with Turner syndrome.

PATIENTS AND METHODS

We analyzed electrocardiograms in 78 girls with Turner syndrome and 50 age-matched control girls. The girls with Turner syndrome had additional cardiac and metabolic evaluations.

RESULTS

Girls with Turner syndrome were more likely to demonstrate > or = 1 electrocardiographic findings including right axis deviation, right ventricular hypertrophy, accelerated atrioventricular conduction, T-wave abnormalities, and a prolonged rate-corrected QT interval. The right-sided findings were associated with partial anomalous pulmonary venous connection, but the etiology of the other findings remains unknown. The rate-corrected QT interval was significantly longer in girls with Turner syndrome (431 +/- 22 vs 407 +/- 21 milliseconds). Twenty-eight girls with Turner syndrome but only 2 controls had a rate-corrected QT interval above the reference range. We found no correlation between body habitus, cardiac dimensions, or metabolic parameters and the rate-corrected QT interval duration in girls with Turner syndrome.

CONCLUSIONS

Cardiac conduction and repolarization abnormalities seem to affect both young girls and adults with Turner syndrome equally, suggesting that electrophysiologic defects are intrinsic to the syndrome and indicating that electrocardiogram analysis should be included in evaluating and monitoring even the youngest patients with Turner syndrome. Attention to the rate-corrected QT interval is important, because some common medications may further prolong this interval and increase the risk of arrhythmias.

摘要

背景

我们最近报道,心电图异常在成年单体X(特纳综合征)患者中很常见,但这一问题尚未在特纳综合征女孩中进行研究。

患者与方法

我们分析了78例特纳综合征女孩和50例年龄匹配的对照女孩的心电图。对特纳综合征女孩进行了额外的心脏和代谢评估。

结果

特纳综合征女孩更有可能出现≥1项心电图表现,包括电轴右偏、右心室肥大、房室传导加速、T波异常以及校正心率后的QT间期延长。右侧表现与部分肺静脉异位连接有关,但其他表现的病因仍不清楚。特纳综合征女孩校正心率后的QT间期明显更长(431±22 vs 407±21毫秒)。28例特纳综合征女孩但只有2例对照的校正心率后的QT间期高于参考范围。我们发现特纳综合征女孩的体型、心脏大小或代谢参数与校正心率后的QT间期持续时间之间没有相关性。

结论

心脏传导和复极异常似乎对特纳综合征的年轻女孩和成年患者影响相同,这表明电生理缺陷是该综合征所固有的,也表明即使是最年幼的特纳综合征患者,心电图分析也应纳入评估和监测中。关注校正心率后的QT间期很重要,因为一些常用药物可能会进一步延长该间期并增加心律失常的风险。

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