Krauss Thomas Timothy, Mäuser Wanda, Reppel Michael, Schunkert Heribert, Bonnemeier Hendrik
Medizinische Klinik II, Universität zu Lübeck, Lübeck, Germany.
Pacing Clin Electrophysiol. 2009 Mar;32 Suppl 1:S167-72. doi: 10.1111/j.1540-8159.2008.02278.x.
Parameters of ventricular repolarization variability are increasingly being used in an attempt to understand better and predict the occurrence of ventricular tachycardia. Nevertheless, some of the measures used have thus far not been analyzed regarding gender differences in a large group of healthy subjects. Furthermore, new parameters might give further insight.
We investigated 139 healthy volunteers (mean age 41.6 +/- 15.3 years, range 20-77, median 40.0 years, 76 women) without evidence of organic cardiac disease. Mean RR interval and established time domain parameters of heart rate variability (rMSSD; SDNN) were measured for each subject. Beat-to-beat QT interval and time-domain QT interval variability were analyzed. Characteristics of the QT interval and QT interval variability were determined as hourly mean values. The standard deviation of all QT intervals/hour (SDQT) and the standard deviation of all QTc intervals/hour (SDQTc) were used to measure QT interval variability. Four novel ratios of repolarization inhomogeneity (VRI: SDQT/SDNN; VR II: SDQT/rMSSD; VR III: SDQTc/SDNN; VR IV: SDQTc/rMSSD) were introduced. Female subjects exhibited significantly higher values in all four ratios of variability.
The obvious gender differences in repolarization inhomogeneity found in this study might be valuable in better understanding differences between men and women in the genesis of ventricular tachycardia.
心室复极变异性参数越来越多地被用于试图更好地理解和预测室性心动过速的发生。然而,迄今为止,所使用的一些测量方法尚未在一大群健康受试者中分析性别差异。此外,新的参数可能会提供进一步的见解。
我们调查了139名无器质性心脏病证据的健康志愿者(平均年龄41.6±15.3岁,范围20 - 77岁,中位数40.0岁,76名女性)。测量了每个受试者的平均RR间期和心率变异性的既定时域参数(rMSSD;SDNN)。分析了逐搏QT间期和时域QT间期变异性。将QT间期和QT间期变异性的特征确定为每小时的平均值。使用所有QT间期/小时的标准差(SDQT)和所有QTc间期/小时的标准差(SDQTc)来测量QT间期变异性。引入了四个新的复极不均匀性比率(VRI:SDQT/SDNN;VR II:SDQT/rMSSD;VR III:SDQTc/SDNN;VR IV:SDQTc/rMSSD)。女性受试者在所有四个变异性比率中均表现出显著更高的值。
本研究中发现的复极不均匀性方面明显的性别差异,可能有助于更好地理解男性和女性在室性心动过速发生机制上的差异。