致心律失常性右室心肌病中的右心室扩大与QRS波振幅降低和T波倒置有关。
Right-ventricular enlargement in arrhythmogenic right-ventricular cardiomyopathy is associated with decreased QRS amplitudes and T-wave negativity.
作者信息
Zusterzeel Robbert, Ter Bekke Rachel M A, Volders Paul G A, Leijten Farah M M, van den Wijngaard Arthur, Serroyen Jan, Gorgels Anton P M
机构信息
Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands.
出版信息
Ann Noninvasive Electrocardiol. 2013 Nov;18(6):555-63. doi: 10.1111/anec.12080. Epub 2013 Sep 9.
BACKGROUND
Arrhythmogenic right-ventricular cardiomyopathy (ARVC) can lead to RV dilatation. We hypothesized that electrocardiographic characteristics including QRS amplitudes in the extremity- and precordial leads, the S amplitude in lead V1 , and extent of T-wave negativity over the precordial leads are related to RV dilatation in this condition.
METHODS
In 42 ARVC patients and 42 controls, we correlated total QRS amplitude in the extremity leads (∑QRSext ), precordial leads (∑QRSprec ) and in all leads (∑QRStot : summation of ∑QRSext and ∑QRSprec ), S amplitude in lead V1 and the extent of T-wave inversion in the precordial leads (V1 vs. beyond V1 ) with RV end diastolic diameter (RVEDD) by echocardiography.
RESULTS
In the ARVC group, the mean age was 46 ± 14 years, 31 patients were male, 28 had an implantable cardioverter defibrillator (ICD), and 7 had a LV ejection fraction (EF) < 55%. The control group was age- and gender matched to the ARVC cohort. In contrast to controls, the ∑QRSext (regression coefficient (RC), -0.29; P = 0.020), ∑QRSprec (RC, -0.20; P = 0.015), and ∑QRStot (RC, -0.14; P = 0.009) were lower with RV dilatation in ARVC. S amplitude in lead V1 was not related to RV diameter (RC, -0.98; P = 0.088). Precordial T-wave inversion beyond lead V1 (V2 -V6 ) was associated with a larger RV diameter (RC, 8.58; P = 0.012).
CONCLUSIONS
Summed QRS amplitudes in the extremity and precordial leads, and T-wave inversion beyond lead V1 are associated with RV dilatation in patients with ARVC.
背景
致心律失常性右室心肌病（ARVC）可导致右室扩张。我们推测，在此情况下，包括肢体导联和胸前导联的QRS波振幅、V1导联的S波振幅以及胸前导联T波倒置程度在内的心电图特征与右室扩张有关。
方法
在42例ARVC患者和42例对照者中，我们通过超声心动图将肢体导联总QRS波振幅（∑QRSext）、胸前导联总QRS波振幅（∑QRSprec）以及所有导联总QRS波振幅（∑QRStot：∑QRSext与∑QRSprec之和）、V1导联S波振幅和胸前导联T波倒置程度（V1导联与V1导联以外导联）与右室舒张末期内径（RVEDD）进行相关性分析。
结果
ARVC组平均年龄为46±14岁，31例为男性，28例植入了植入式心律转复除颤器（ICD），7例左室射血分数（EF）<55%。对照组在年龄和性别上与ARVC队列相匹配。与对照组相比，ARVC患者右室扩张时，∑QRSext（回归系数（RC），-0.29；P = 0.020）、∑QRSprec（RC，-0.20；P = 0.015）和∑QRStot（RC，-0.14；P = 0.009）较低。V1导联S波振幅与右室直径无关（RC，-0.98；P = 0.088）。V1导联以外导联（V2 - V6）的胸前导联T波倒置与更大的右室直径相关（RC，8.58；P = 0.012）。
结论
ARVC患者肢体导联和胸前导联的QRS波振幅总和以及V1导联以外导联的T波倒置与右室扩张有关。
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