Koturoglu G, Kurugol Z, Levent E
Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey.
Minerva Pediatr. 2006 Dec;58(6):575-7.
QT prolongation is rarely seen after acute stress reactions such as burn injury and severe head trauma. Although pathophysiologic mechanism is not entirely clear, acute stress is thought to contribute to the inhomogeneity of ventricular repolarization and it is hypothesized that QTc dispersion increases with severity of acute stress conditions. In the present study, we report long QT syndrome in 2 patients with minor head trauma. Their QTc intervals, i.e. QT intervals corrected for heart rate by the standard Bazett formula, were found to be prolonged (545 and 450 ms, respectively) without creatine phosphokinase - MB elevation. These findings suggest that myocardial effects may occur as a result of probable catecholamine discharge, even if they are not at a level to affect creatine phosphokinase - MB values in minor head trauma. But these findings have not been supported by experimental data, for this reason we need a lot of study in order to confirm this hypothesis.
QT间期延长在诸如烧伤和严重头部创伤等急性应激反应后很少见。尽管病理生理机制尚不完全清楚，但急性应激被认为会导致心室复极的不均一性，并且据推测QTc离散度会随着急性应激状况的严重程度而增加。在本研究中，我们报告了2例轻度头部创伤患者出现长QT综合征。他们的QTc间期，即通过标准Bazett公式校正心率后的QT间期，被发现延长（分别为545和450毫秒），而肌酸磷酸激酶-MB没有升高。这些发现表明，即使在轻度头部创伤中儿茶酚胺释放水平未达到影响肌酸磷酸激酶-MB值的程度，也可能由于儿茶酚胺释放而产生心肌效应。但这些发现尚未得到实验数据的支持，因此我们需要进行大量研究以证实这一假设。
