Lupoqlazoff Jean-Marc, Denjoy Isabelle
Unité de cardiologie néonatale, hôpital Robert-Debré, 75935 Paris.
Rev Prat. 2007 Jan 31;57(2):121-5.
Short QT syndrome is a newly described cardiologic entity which associates a short OT interval (QT and QTc < or = 300 ms) on the surface ECG to a high risk of syncope or sudden death due to malignant ventricular arrhythmia. This extremely rare syndrome affects mainly young adults or infants and has a wide clinical expression. It is frequently associated with atrial fibrillation. Mutations in 3 different genes KCNQ1, KCNH2, and KCNJ2, all encoding cardiac ionic potassium channels have been identified in affected patients. The clinical spectrum is very wide ranging from asymptomatic carriers to syncope or sudden death. It is an autosomal dominant transmission. Expression studies have shown a gain of function and a shortening of the action potential duration thus explaining the short OT interval. At electrophysiologic study, atrial and ventricular refractory periods are short, and ventricular fibrillation inducible in the majority of patients. As of today, automatic implantable defibrillator is the only effective treatment for the prevention of sudden death in the short QT syndrome.
短QT综合征是一种新描述的心脏疾病,其体表心电图表现为QT间期缩短(QT及QTc≤300毫秒),且因恶性室性心律失常导致晕厥或猝死风险较高。这种极其罕见的综合征主要影响年轻人或婴儿,临床表现多样,常伴有心房颤动。在受影响的患者中已鉴定出3种不同基因(KCNQ1、KCNH2和KCNJ2)发生突变,这些基因均编码心脏离子钾通道。临床谱非常广泛,从无症状携带者到晕厥或猝死。它呈常染色体显性遗传。表达研究显示存在功能增强及动作电位时程缩短,从而解释了QT间期缩短的原因。在电生理研究中,心房和心室不应期较短,大多数患者可诱发心室颤动。截至目前,自动植入式除颤器是预防短QT综合征猝死的唯一有效治疗方法。