Department of Cardiology, Meram School of Medicine, Selcuk University, Konya, Turkey.
Int J Med Sci. 2012;9(1):93-102. doi: 10.7150/ijms.9.93. Epub 2011 Dec 14.
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.
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.
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).
The present study demonstrated that PV may be associated with electrocardiographic abnormalities of both atrium and ventricle.
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。
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。
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)。
本研究表明,PV 可能与心房和心室的心电图异常有关。