Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Epidemiology. 2011 Sep;22(5):660-70. doi: 10.1097/EDE.0b013e318225768b.
Extremely abnormal prolongation of the electrocardiographic QT interval is associated with malignant ventricular arrhythmias and sudden cardiac death. However, the implications of variations in QT-interval length within normal limits for mortality in the general population are still unclear.
We performed a meta-analysis to investigate the relation of QT interval with mortality endpoints. Inverse-variance weighted random-effects models were used to summarize the relative risks across studies. Twenty-three observational studies were included.
The pooled relative risk estimates comparing the highest with the lowest categories of QT-interval length were 1.35 (95% confidence interval = 1.24-1.46) for total mortality, 1.51 (1.29-1.78) for cardiovascular mortality, 1.71 (1.36-2.15) for coronary heart disease mortality, and 1.44 (1.01-2.04) for sudden cardiac death. A 50 milliseconds increase in QT interval was associated with a relative risk of 1.20 (1.15-1.26) for total mortality, 1.29 (1.15-1.46) for cardiovascular mortality, 1.49 (1.25-1.76) for coronary heart disease mortality, and 1.24 (0.97-1.60) for sudden cardiac death.
We found consistent associations between prolonged QT interval and increased risk of total, cardiovascular, coronary, and sudden cardiac death. QT-interval length is a determinant of mortality in the general population.
心电图 QT 间期极度异常延长与恶性室性心律失常和心脏性猝死有关。然而，正常范围内 QT 间期长度的变化对普通人群死亡率的影响仍不清楚。
我们进行了一项荟萃分析，以研究 QT 间期与死亡率终点的关系。采用逆方差加权随机效应模型汇总研究间的相对风险。共纳入 23 项观察性研究。
比较 QT 间期最长和最短组的汇总相对风险估计值分别为总死亡率 1.35（95%置信区间 1.24-1.46）、心血管死亡率 1.51（1.29-1.78）、冠心病死亡率 1.71（1.36-2.15）和心脏性猝死 1.44（1.01-2.04）。QT 间期增加 50 毫秒与总死亡率的相对风险为 1.20（1.15-1.26）、心血管死亡率 1.29（1.15-1.46）、冠心病死亡率 1.49（1.25-1.76）和心脏性猝死 1.24（0.97-1.60）相关。
我们发现 QT 间期延长与总死亡率、心血管死亡率、冠心病死亡率和心脏性猝死风险增加之间存在一致的关联。QT 间期长度是普通人群死亡率的决定因素。
