在一项全面的QT研究中，对男性和女性在12个心电图导联中分别测量QT间期时的药物诱导的QT延长。
Drug-induced QT prolongation when QT interval is measured in each of the 12 ECG leads in men and women in a thorough QT study.
作者信息
Panicker Gopi Krishna, Salvi Vaibhav, Karnad Dilip R, Chakraborty Saikat, Manohar Deepak, Lokhandwala Yash, Kothari Snehal
机构信息
Quintiles Cardiac Safety Services, Mumbai, India.
Quintiles Cardiac Safety Services, Mumbai, India.
出版信息
J Electrocardiol. 2014 Mar-Apr;47(2):155-7. doi: 10.1016/j.jelectrocard.2013.11.004. Epub 2013 Nov 27.
Lead II is commonly used to study drug-induced QT prolongation. Whether other ECG leads too show comparable QT prolongation is not known. We studied moxifloxacin-induced QT prolongation in a thorough QT study in healthy subjects (54 males, 43 females). Placebo-subtracted change from baseline in QTc corrected by Fridericia's method (ΔΔQTcF) at 1, 1.5, 2 and 4 hours after moxifloxacin was studied in all 12 leads. Unacceptably wide 90% confidence interval (CI) for ΔΔQTcF was seen in three leads; these leads also had maximum ECGs with flat T waves (60% in aVL, 45% in lead III and 42% in V1). After excluding ECGs with flat T waves, 90% lower CI of ΔΔQTcF was ≥ 5 ms in all leads except leads III, aVL and V1 in men. The 90% lower CI exceeded 5 ms in these leads in women despite wide 90% CIs because of greater mean ΔΔQTcF. Leads III, aVL and V1 should be avoided when measuring QT interval in thorough QT studies.
II导联常用于研究药物引起的QT间期延长。其他心电图导联是否也会出现类似的QT间期延长尚不清楚。我们在一项针对健康受试者（54名男性，43名女性）的全面QT研究中，研究了莫西沙星引起的QT间期延长。在莫西沙星给药后1、1.5、2和4小时，对所有12个导联采用弗里德里西亚法校正的QTc（ΔΔQTcF）从基线的安慰剂校正变化进行了研究。在三个导联中观察到ΔΔQTcF的90%置信区间（CI）宽得不可接受；这些导联的最大心电图还伴有T波平坦（aVL导联为60%，III导联为45%，V1导联为42%）。排除T波平坦的心电图后，除男性的III导联、aVL导联和V1导联外，所有导联的ΔΔQTcF的90%下限CI≥5 ms。尽管90%CI较宽，但由于平均ΔΔQTcF较大，女性这些导联的90%下限CI超过了5 ms。在全面QT研究中测量QT间期时，应避免使用III导联、aVL导联和V1导联。
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