Kılıçkesmez Kadriye Orta, Bulut Gülsüm, Başkurt Murat, Coşkun Uğur, Yıldız Ahmet, Küçükoğlu Serdar
Department of Cardiology, Cardiology Institute, İstanbul University, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2011 Apr;39(3):183-90. doi: 10.5543/tkda.2011.01230.
We evaluated the value of QT interval dispersion in patients with rheumatic mitral stenosis (MS) in association with echocardiographic parameters and serum N-terminal pro brain natriuretic peptide (NT-proBNP) levels.
The study consisted of 46 patients (39 women, 7 men; mean age 46.9±9.7 years) with moderate-to-severe rheumatic MS. All patients underwent echocardiographic examination. Blood samples for NT-proBNP were collected immediately after ECG recording. QT interval and QRS complex were measured manually on standard 12-lead surface ECGs. Electrocardiographic and echocardiographic findings and serum NT-proBNP levels were compared with those of a control group consisting of 30 healthy subjects (26 women, 4 men; mean age 46.1±7.3 years).
Compared to controls, serum NT-proBNP levels were significantly higher in MS patients (284.6±206.5 vs. 70.2±9.3 pg/ml, p<0.001). The mean QT interval, QTc interval, and QT dispersion were significantly prolonged in MS patients compared to controls (378±25 vs. 349±21, 420±22 vs. 401±19, and 61±21 vs. 38±15 msec, respectively; p<0.005). QT and QTc dispersions were negatively correlated with mitral valve area (QT: r=-0.311, p=0.03; QTc: r=-0.327, p=0.02), and positively correlated with serum NT-proBNP level (QT: r=0.583, p<0.001; QTc: r=0.637, p<0.001). QTc dispersion was also an independent predictor of serum NT-proBNP level in regression analysis (β=0.330, p=0.03).
Our results indicate that QT dispersion is related to the echocardiographic degree of rheumatic mitral valve disease and serum NT-proBNP levels in rheumatic MS. Being a noninvasive, easy, and inexpensive method, QT dispersion may be used as a complementary tool to the clinical and echocardiographic evaluation of patients with rheumatic MS.
我们评估了风湿性二尖瓣狭窄（MS）患者QT间期离散度与超声心动图参数及血清N末端脑钠肽前体（NT-proBNP）水平之间的关系。
该研究纳入了46例中重度风湿性MS患者（39例女性，7例男性；平均年龄46.9±9.7岁）。所有患者均接受了超声心动图检查。在心电图记录后立即采集用于检测NT-proBNP的血样。在标准12导联体表心电图上手动测量QT间期和QRS波群。将心电图和超声心动图检查结果以及血清NT-proBNP水平与由30名健康受试者组成的对照组（26例女性，4例男性；平均年龄46.1±7.3岁）进行比较。
与对照组相比，MS患者的血清NT-proBNP水平显著更高（284.6±206.5对70.2±9.3 pg/ml，p<0.001）。与对照组相比，MS患者的平均QT间期、校正QT间期（QTc）和QT离散度均显著延长（分别为378±25对349±21、420±22对401±19以及61±21对38±15毫秒；p<0.005）。QT离散度和QTc离散度与二尖瓣面积呈负相关（QT：r=-0.311，p=0.03；QTc：r=-0.327，p=0.02），与血清NT-proBNP水平呈正相关（QT：r=0.583，p<0.001；QTc：r=0.637，p<0.001）。在回归分析中，QTc离散度也是血清NT-proBNP水平的独立预测因子（β=0.330，p=0.03）。
我们的结果表明，QT离散度与风湿性二尖瓣疾病的超声心动图严重程度以及风湿性MS患者的血清NT-proBNP水平相关。作为一种无创、简便且廉价的方法，QT离散度可作为风湿性MS患者临床和超声心动图评估的补充工具。
