Remigio de Aguiar Maria I, Saraiva Lurildo C Ribeiro, Santos Cleusa L
Department of Cardiovascular Science, Clinical Hospital, Pernambuco Federal University, Recife-Pernambuco, Brazil.
Cardiol Young. 2010 Oct;20(5):473-6. doi: 10.1017/S1047951109991442. Epub 2010 Jun 17.
To investigate QT dispersion in the surface electrocardiogram of children with rheumatic carditis.
QT dispersion was quantitatively evaluated in 33 children with acute rheumatic carditis. As a control group, we studied 33 healthy children free of any disease. The children were eligible for participation if the following criteria were met: diagnosis of acute rheumatic fever based on the revised Jone's criteria and suffering from their first attack of carditis. The echo Doppler cardiogram was performed in all children, within 48-72 hours of hospitalisation.
Patients with carditis had a greater QT dispersion than the control group. When we analyse the QT dispersion according to the severity of the carditis, we observed that the dispersion tended to be greater in those with more severe valvar lesion. The sensitivity and specificity of the measurements of the QT dispersion in predicting acute carditis were estimated by using receiver operating characteristic curves. A QT dispersion greater than 40 milliseconds had a sensitivity of 63.6% and a specificity of 93.9% in predicting acute rheumatic carditis.
The lengthening of QT dispersion may reflect on cardiac involvement in rheumatic fever and be a new important parameter in the diagnosis and therapeutic decision for rheumatic carditis.
研究风湿性心脏炎患儿体表心电图的QT离散度。
对33例急性风湿性心脏炎患儿的QT离散度进行定量评估。作为对照组，我们研究了33例无任何疾病的健康儿童。符合以下标准的儿童有资格参与：根据修订的琼斯标准诊断为急性风湿热且首次发作心脏炎。所有儿童在住院48 - 72小时内进行了超声心动图检查。
心脏炎患儿的QT离散度大于对照组。当我们根据心脏炎的严重程度分析QT离散度时，我们观察到瓣膜病变越严重的患儿，其离散度往往越大。通过使用受试者工作特征曲线来估计QT离散度测量在预测急性心脏炎方面的敏感性和特异性。QT离散度大于40毫秒在预测急性风湿性心脏炎时的敏感性为63.6%，特异性为93.9%。
QT离散度延长可能反映风湿热累及心脏，并且是风湿性心脏炎诊断和治疗决策中的一个新的重要参数。
