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真性红细胞增多症患者的心电图表现。

Electrocardiographic findings in patients with polycythemia vera.

机构信息

Department of Cardiology, Meram School of Medicine, Selcuk University, Konya, Turkey.

出版信息

Int J Med Sci. 2012;9(1):93-102. doi: 10.7150/ijms.9.93. Epub 2011 Dec 14.

Abstract

BACKGROUND

The 12-lead surface electrocardiogram (ECG) is a useful tool to predict both atrial and ventricular arrhythmias via P-wave and QT measurements and its derivatives. Polycythemia vera (PV) is a chronic myeloproliferative disorder associated with cardiovascular events. The aim of this study was to assess ECG findings of patients with PV.

METHOD AND MATERIALS

Sixty patients with PV (34 male, mean age 58±11 years) and 60 age and gender-matched healthy volunteers were enrolled into the study. From the 12-lead surface ECG, P-wave and both conventional QT measurements and transmyocardial repolarization parameters (T(peak)-T(end) interval (T(p)-T(e)) and derivatives) were evaluated digitally by two experienced cardiologists. In addition, a novel parameter, Pi was calculated digitally as the standard deviation of the P-wave duration across the 12 ECG leads.

RESULTS

QT duration and corrected QT interval were significantly longer in the PV group compared to healthy controls (p<0.01 and p<0.01, respectively). The T(p)-T(e) was longer and the T(p)-T(e)/QT ratio was significantly higher in the PV group compared to the controls. P-wave analyses showed that all P-wave parameters including Pmax, Pmin, P dispersion, and Pi were significantly prolonged in PV patients compared to the controls. The increase of both T(p)-T(e )and P max in the PV group was independent of age, BMI, diabetes and hypertension, gender, systolic blood pressure, hemoglobin, hematocrit, left atrial dimension, left ventricular end-diastolic diameter and early deceleration time in a univariate analysis of co-variance model (F=11.097, p=0.001 and F=31.537, p=0.0001, respectively).

CONCLUSION

The present study demonstrated that PV may be associated with electrocardiographic abnormalities of both atrium and ventricle.

摘要

背景

12 导联体表心电图(ECG)是一种通过 P 波及 QT 测量及其衍生指标来预测房性和室性心律失常的有用工具。真性红细胞增多症(PV)是一种与心血管事件相关的慢性骨髓增生性疾病。本研究旨在评估 PV 患者的心电图表现。

方法和材料

共纳入 60 例 PV 患者(34 名男性,平均年龄 58±11 岁)和 60 名年龄和性别匹配的健康志愿者作为对照组。通过 12 导联体表心电图,由两位有经验的心脏病专家对 P 波及传统 QT 测量以及透壁复极参数(T(peak)-T(end)间期(T(p)-T(e))和衍生指标)进行数字化评估。此外,还通过数字化计算了一个新参数 Pi,即 12 导联心电图上 P 波时限的标准差。

结果

与对照组相比,PV 组的 QT 间期和校正 QT 间期明显延长(p<0.01 和 p<0.01)。PV 组的 T(p)-T(e)更长,T(p)-T(e)/QT 比值明显高于对照组。与对照组相比,PV 患者的所有 P 波参数(包括 Pmax、Pmin、P 离散度和 Pi)均显著延长。在单因素协方差模型分析中,PV 组 T(p)-T(e)和 Pmax 的增加均与年龄、BMI、糖尿病和高血压、性别、收缩压、血红蛋白、血细胞比容、左心房内径、左心室舒张末期直径和早期减速时间无关(F=11.097,p=0.001 和 F=31.537,p=0.0001)。

结论

本研究表明,PV 可能与心房和心室的心电图异常有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2888/3245418/6dd91482e1c3/ijmsv09p0093g01.jpg

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