Sap Fatih, Karataş Zehra, Altin Hakan, Alp Hayrullah, Oran Bülent, Baysal Tamer, Karaarslan Sevim
Department of Pediatric Cardiology, Konya Training and Research Hospital, Meram Yeniyol Street, Number: 97 Meram, Konya, Turkey.
Pediatr Cardiol. 2013 Mar;34(3):591-6. doi: 10.1007/s00246-012-0503-5. Epub 2012 Sep 13.
This study aimed to investigate homogeneity disorders of ventricular repolarization and atrial conduction via QT dispersion and P-wave dispersion in children with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH). Three groups of 20 each were generated and involved in this study. The first group included 20 children with both CHD and PAH. The second group consisted of 20 children with CHD but no PAH, and the third group was composed of 20 age- and sex-matched healthy children. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. The pulmonary hypertension group compared with the group having no pulmonary hypertension and the control group showed a significantly longer P-wave dispersion duration (39.10 ± 9.54 vs. 26.30 ± 4.99 ms, p < 0.001; and 24.80 ± 6.94 ms, p < 0.001, respectively) and QT dispersion duration (52.80 ± 15.11 vs. 37.60 ± 6.00 ms, p < 0.001; and 35.00 ± 7.77 ms, p < 0.001, respectively). In addition, the durations of maximum QTc and QTc dispersion were significantly longer in pulmonary hypertension group than in the other two groups. The risk of atrial and ventricular arrhythmia was found to be increased in the patients with both CHD and PAH. Physicians should pay close attention to possible atrial and ventricular arrhythmias during the treatment and follow-up evaluation of these patients.
本研究旨在通过先天性心脏病（CHD）和肺动脉高压（PAH）患儿的QT离散度和P波离散度来研究心室复极和心房传导的均匀性障碍。研究共纳入三组，每组20人。第一组包括20名患有CHD和PAH的儿童。第二组由20名患有CHD但无PAH的儿童组成，第三组由20名年龄和性别匹配的健康儿童组成。采用心电图记录来测定P波、QT及校正QT（QTc）离散度。与无肺动脉高压组和对照组相比，肺动脉高压组的P波离散度持续时间显著更长（分别为39.10±9.54 vs. 26.30±4.99 ms，p<0.001；以及24.80±6.94 ms，p<0.001），QT离散度持续时间也显著更长（分别为52.80±15.11 vs. 37.60±6.00 ms，p<0.001；以及35.00±7.77 ms，p<0.001）。此外，肺动脉高压组的最大QTc和QTc离散度持续时间显著长于其他两组。发现患有CHD和PAH的患者发生房性和室性心律失常的风险增加。医生在这些患者的治疗和随访评估过程中应密切关注可能出现的房性和室性心律失常。
