Eslami Vahid, Safi Morteza, Taherkhani Maryam, Adibi Ali, Movahed Mohammad Reza
Shahid Beheshti University of Medical Sciences. Cardiovascular Research Center, Tehran, Iran.
J Invasive Cardiol. 2013 May;25(5):232-4.
Acute ST-elevation myocardial infarction (STEMI) is associated with significant arrhythmia and cardiac arrest. QT prolongation can occur in the setting of ischemia or acute STEMI as a risk factor for arrhythmia. The goal of this study was to investigate corrected QT interval (QTc), QT dispersion (QTd), and T-wave peak to end (TPE) times in this patient population and evaluate the effect of primary percutaneous coronary intervention (PCI) in STEMI patients on these indices.
This study was a clinical trial, whereby eligible patients presenting with acute STEMI who were appropriate candidates for primary PCI were enrolled. QTc, QTd, and TPE indices were calculated before and after the procedure.
Eighty patients (60 male, 20 female) with a mean age of 58.8 years were evaluated. We found significant reduction in QTd after PCI (mean, 5.8 ms before PCI vs 3.6 ms after PCI; P<.001) and significant reduction in TPE after PCI (mean, 9.7 ms before PCI vs 7 ms after PCI; P<.001). QTc did not show significant changes before or after PCI (44.9 vs 43.7; P=.057).
Our study showed that primary PCI was effective in reducing the degree of arrhythmogenic indices such as QTd and TPE. Our findings suggest that ischemia-induced QTd and TPE are important arrhythmogenic parameters responding to successful primary PCI and may be used as markers for successful repercussion.
急性ST段抬高型心肌梗死(STEMI)与严重心律失常和心脏骤停相关。QT间期延长可发生于缺血或急性STEMI时,是心律失常的一个危险因素。本研究的目的是调查该患者群体的校正QT间期(QTc)、QT离散度(QTd)和T波峰末间期(TPE),并评估急性STEMI患者的直接经皮冠状动脉介入治疗(PCI)对这些指标的影响。
本研究为一项临床试验,纳入适合进行直接PCI的急性STEMI患者。在手术前后计算QTc、QTd和TPE指标。
评估了80例患者(60例男性,20例女性),平均年龄58.8岁。我们发现PCI后QTd显著降低(PCI前平均为5.8毫秒,PCI后为3.6毫秒;P<0.001),PCI后TPE也显著降低(PCI前平均为9.7毫秒,PCI后为7毫秒;P<0.001)。QTc在PCI前后未显示出显著变化(44.9对43.7;P=0.057)。
我们的研究表明,直接PCI可有效降低QTd和TPE等致心律失常指标的程度。我们的研究结果表明,缺血诱导的QTd和TPE是对成功的直接PCI有反应的重要致心律失常参数,可作为成功再灌注的标志物。