Tandogan Izzet, Aslan Halil, Aksoy Yuksel, Topal Ergun, Turgut Okan, Yilmaz Ahmet, Acikgoz Nusret, Kosar Feridun, Ozdemir Ramazan
Department of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey.
Coron Artery Dis. 2006 Nov;17(7):623-8. doi: 10.1097/01.mca.0000224417.21563.8a.
The aim of this study was to assess the effect of coronary collateral circulation (CCC) on QT dispersion (QTD) in coronary artery disease.
A prolonged QTD has been linked to increased heterogeneity of ventricular repolarization implicated in the genesis of ventricular arrhythmias and has been associated with an adverse prognosis in patients with coronary artery disease.
CCC and corrected QTD (QTcD) were established in patients who had at least 85% stenosis in the left anterior descending coronary artery or in proximal part or in the body of the right coronary artery. Furthermore, left ventricular function score was determined for all the patients.
While CCC was not present (CCC grade 0) in 32 patients, 68 patients were observed with CCC (CCC grade > or =1). Mean QTcD was higher in patients who had CCC grade > or =1 than in patients with grade 0 (64.3+/-3.5 and 46.8+/-2.7, respectively, P=0.002). We detected a significant correlation between the collateral score and QTcD (r=0.354, P=0.001). CCC grade > or =1 patients had higher mean left ventricular function scores than grade 0 patients (P=0.048). Left ventricular function score and QTcD were observed to be correlated (r=0.200, P=0.046).
CCC in chronic coronary artery disease was not established to have a positive decreasing effect on QTcD. On the contrary, QTcD values were observed to be even higher in patients with well developed CCC. Further research including larger series and long-term follow-up is required to investigate this issue.
本研究旨在评估冠状动脉侧支循环（CCC）对冠心病患者QT离散度（QTD）的影响。
QT间期延长与心室复极异质性增加有关，这与室性心律失常的发生有关，并与冠心病患者的不良预后相关。
对左前降支冠状动脉或右冠状动脉近端或主干至少有85%狭窄的患者进行CCC和校正QT离散度（QTcD）测定。此外，还对所有患者进行了左心室功能评分。
32例患者无CCC（CCC分级0级），68例患者有CCC（CCC分级≥1级）。CCC分级≥1级患者的平均QTcD高于0级患者（分别为64.3±3.5和46.8±2.7，P = 0.002）。我们检测到侧支循环评分与QTcD之间存在显著相关性（r = 0.354，P = 0.001）。CCC分级≥1级患者的平均左心室功能评分高于0级患者（P = 0.048）。观察到左心室功能评分与QTcD相关（r = 0.200，P = 0.046）。
慢性冠心病中的CCC对QTcD未显示出积极的降低作用。相反，在CCC发育良好的患者中，QTcD值甚至更高。需要进一步开展包括更大样本量和长期随访的研究来调查这一问题。
