Nigro Gerardo, Russo Vincenzo, Di Salvo Giovanni, De Crescenzo Ilaria, Rago Anna, Perrone Laura, Golino Paolo, Russo Maria Giovanna, Calabrò Raffaele
Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy.
Pacing Clin Electrophysiol. 2010 Dec;33(12):1533-9. doi: 10.1111/j.1540-8159.2010.02889.x. Epub 2010 Oct 14.
Obese children, without arterial hypertension, may be a unique clinical opportunity to evaluate the effect of obesity, per se, on ventricular repolarization, excluding the influence of possible comorbidities. The QTc dispersion (QTc-d), JTc dispersion (JTc-d), and transmural dispersion of repolarization (TDR) have been suggested to be electrocardiographic indexes reflecting the physiological variability of regional ventricular repolarization. The aim of our study is to define the effects of obesity on the ventricular repolarization in obese children who have no other clinically appreciable cause of heart disease.
The study involved 70 subjects (48 male, 22 female), with a mean age (± standard deviation) of 13 ± 2 years. A total of 35 individuals were obese (Group A: 24 male, 11 female, mean body mass index [BMI] of 38.2 ± 5.8 kg/m(2) ), and 35 participants were healthy lean children (Group C: 24 male, 11 female, mean BMI of 22.3 ± 0.3 kg/m(2) ). Heart rate; QRS duration; maximum and minimum QT interval; and QTc-d, JTc-d, and TDR measurement were performed.
Compared with the healthy control group, obese children presented increased values of the QTc-d, JTc-d, and TDR (31.1 ± 10.6 vs 46.2 ± 15.3 ms, P < 0.003; 29.8 ± 8.5 vs 40.1 ± 10.3 ms, P < 0.04; 83.2 ± 13.5 vs 100.7 ± 16.3 ms, P < 0.05). A statistically significant correlation was found between the values of QTc-d, insulin serum concentration (r = 0.46, P = 0.04), and homeostasis model assessment of insulin resistance (r = 0.34, P = 0.03).
Our data suggest that obese nonhypertensive children have an increased ventricular repolarization heterogeneity in relation to controls.
对于没有动脉高血压的肥胖儿童，可能是一个独特的临床机会，可用于评估肥胖本身对心室复极的影响，排除可能的合并症的影响。QTc离散度（QTc-d）、JTc离散度（JTc-d）和复极跨壁离散度（TDR）已被认为是反映局部心室复极生理变异性的心电图指标。我们研究的目的是确定肥胖对没有其他临床上明显心脏病病因的肥胖儿童心室复极的影响。
该研究纳入70名受试者（48名男性，22名女性），平均年龄（±标准差）为13±2岁。共有35人肥胖（A组：24名男性，11名女性，平均体重指数[BMI]为38.2±5.8kg/m²），35名参与者为健康瘦儿童（C组：24名男性，11名女性，平均BMI为22.3±0.3kg/m²）。测量心率、QRS波时限、最大和最小QT间期以及QTc-d,JTc-d和TDR。
与健康对照组相比，肥胖儿童的QTc-d、JTc-d和TDR值升高（31.1±10.6对46.2±15.3ms，P<0.003；29.8±8.5对40.1±10.3ms，P<0.04；83.2±13.5对100.7±16.3ms，P<0.05）。在QTc-d值、胰岛素血清浓度（r=0.46，P=0.04）和胰岛素抵抗稳态模型评估（r=0.34，P=0.03）之间发现了统计学上的显著相关性。
我们的数据表明，与对照组相比，肥胖的非高血压儿童心室复极异质性增加。
