Gupta Prasad, Patel Chinmay, Patel Harsh, Narayanaswamy Srinivasa, Malhotra Binu, Green Jared T, Yan Gan-Xin
Main Line Health Heart Center, Wynnewood, PA 19096, USA.
J Electrocardiol. 2008 Nov-Dec;41(6):567-74. doi: 10.1016/j.jelectrocard.2008.07.016. Epub 2008 Sep 14.
An increasing number of basic and clinical studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (T(p-e)) may correspond to the transmural dispersion of repolarization and that amplification of the T(p-e) interval is associated with malignant ventricular arrhythmias. In this review, we outline the utility of the T(p-e) interval and the T(p-e)/QT ratio as an electrocardiographic index of arrhythmogenesis for both congenital and acquired ion channel disease leading to ventricular arrhythmias. In healthy individuals, the T(p-e)/QT ratio has a mean value of approximately 0.21 in the precordial leads and it remains relatively constant between the heart rates from 60 to 100 beats per minute. Interestingly, the T(p-e)/QT ratio is significantly greater in the patients at risk for arrhythmic event such as those with long QT syndrome, Brugada syndrome, short QT syndrome, and also in patients with organic heart disease such as acute myocardial infarction. Functional reentry is the underlying mechanism for arrhythmogenesis associated with an increased T(p-e)/QT ratio.
越来越多的基础和临床研究表明，心电图T波从峰值到结束的间期（T(p-e)）可能与复极的跨壁离散度相对应，并且T(p-e)间期的延长与恶性室性心律失常相关。在本综述中，我们概述了T(p-e)间期和T(p-e)/QT比值作为心律失常发生的心电图指标在导致室性心律失常的先天性和获得性离子通道疾病中的应用。在健康个体中，胸前导联的T(p-e)/QT比值平均值约为0.21，并且在心率每分钟60至100次之间相对保持恒定。有趣的是，在有发生心律失常事件风险的患者中，如长QT综合征、Brugada综合征、短QT综合征患者，以及患有急性心肌梗死等器质性心脏病的患者中，T(p-e)/QT比值显著更高。功能性折返是与T(p-e)/QT比值增加相关的心律失常发生的潜在机制。
