Yilmaz Mehmet Birhan, Engin Aynur, Bektasoglu Gokhan, Zorlu Ali, Ege Meltem Refiker, Bakir Mehmet, Dokmetas Ilyas
Department of Cardiology, Cumhuriyet University School of Medicine, 58140 Sivas, Turkey.
J Vector Borne Dis. 2011 Sep;48(3):150-4.
BACKGROUND & OBJECTIVES: Crimean - Congo hemorrhagic fever is an acute viral hemorrhagic fever with considerable mortality. Despite increasing knowledge about hemorrhagic fever viruses, the pathogenesis of Crimean -Congo hemorrhagic fever and causes of death were not well described. We aimed to evaluate whether there were electrocardiographic parameters designating mortality among these patients.
This retrospective study was performed among confirmed Crimean -Congo hemorrhagic fever cases in Turkey. Electrocardiography was available in 49 patients within 24 h of hospitalization. All electrocardiograms were evaluated by two expert cardiologists according to Minnesota coding system.
Among patients with available electrocardiograms, there were 31 patients who survived, and 18 patients who died of Crimean - Congo hemorrhagic fever. Both groups were similar in terms of age, sex, body temperature, heart rate, and blood parameters. T-wave changes and bundle branch block were more frequently encountered among those who died. Presence of T-wave negativity or bundle branch block in this cohort of patients with Crimean -Congo hemorrhagic fever predicted death with a sensitivity of 72.7%, specificity of 92.6%, positive predictive value of 88.9%, negative predictive value of 80.6%.
We think within the light of our findings that simple electrocardiography at admission may help risk stratification among Crimean-Congo hemorrhagic fever cases.
克里米亚-刚果出血热是一种具有相当高死亡率的急性病毒性出血热。尽管对出血热病毒的了解不断增加,但克里米亚-刚果出血热的发病机制和死亡原因仍未得到充分描述。我们旨在评估这些患者中是否存在指示死亡率的心电图参数。
本回顾性研究在土耳其确诊的克里米亚-刚果出血热病例中进行。49例患者在住院24小时内进行了心电图检查。所有心电图均由两位心脏病专家根据明尼苏达编码系统进行评估。
在有心电图检查结果的患者中,有31例存活,18例死于克里米亚-刚果出血热。两组在年龄、性别、体温、心率和血液参数方面相似。死亡患者中T波改变和束支传导阻滞更为常见。在这组克里米亚-刚果出血热患者中,T波倒置或束支传导阻滞的存在预测死亡的敏感性为72.7%,特异性为92.6%,阳性预测值为88.9%,阴性预测值为80.6%。
根据我们的研究结果,我们认为入院时简单的心电图检查可能有助于对克里米亚-刚果出血热病例进行风险分层。