Ece Ibrahim, Üner Abdurrahman, Ballı Şevket, Oflaz Mehmet Burhan, Kibar Ayşe Esin, Sal Ertan
Department of Pediatric Cardiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey.
Department of Pediatric Cardiology, Balıkesir Atatürk Hospital, Balıkesir, Turkey.
Turk Kardiyol Dern Ars. 2014 Mar;42(2):154-60. doi: 10.5543/tkda.2014.68704.
P-wave and QT dispersion are increased and associated with atrial and ventricular arrhythmia and an increase in sudden death in a variety of diseases. This study aimed to investigate P-wave and QT dispersion in children with Eisenmenger syndrome (ES).
The study group included 27 children (15 females, 12 males) with both congenital heart disease (CHD) and ES. The control group consisted of 30 children with CHD without pulmonary arterial hypertension. Electrocardiographic records were used to determine P-wave, QT, and corrected QT (QTc) dispersions. 24-hour (h) rhythm Holter was fitted in all patients. Atrial volumes, ventricular dimensions and tricuspid annular plane systolic excursion (TAPSE) were measured by echocardiography.
There was no difference between groups with regard to age, sex, weight, and body surface area (p>0.05). Right atrial volume was significantly larger in the ES group than in the control group. P-wave, QT and QTc dispersions were higher in the patients with ES (50.10±11.12 vs. 26.32±8.90, p<0.001; 57.40±24.21 vs. 38.20±8.92 ms, p<0.001; and 78.20±16.02 vs. 56.52±13.92 ms, p<0.001, respectively). Ventricular and supraventricular ectopy were significantly more frequent in the ES group. Four patients (14.8%) in the study group had tachyarrhythmias during 24-h Holter monitoring.
In our study, P-wave and QT dispersion were found to be greater in children with ES than in the healthy control subjects.
P波离散度和QT离散度增加,并与多种疾病中的房性和室性心律失常以及猝死风险增加相关。本研究旨在调查艾森曼格综合征(ES)患儿的P波离散度和QT离散度。
研究组包括27例患有先天性心脏病(CHD)和ES的儿童(15例女性,12例男性)。对照组由30例无肺动脉高压的CHD患儿组成。采用心电图记录来测定P波、QT及校正QT(QTc)离散度。所有患者均佩戴24小时动态心电图监测仪。通过超声心动图测量心房容积、心室大小及三尖瓣环平面收缩期位移(TAPSE)。
两组在年龄、性别、体重和体表面积方面无差异(p>0.05)。ES组的右心房容积显著大于对照组。ES患者的P波、QT和QTc离散度更高(分别为50.10±11.12 对比 26.32±8.90,p<0.001;57.40±24.21对比38.20±8.92毫秒,p<0.001;以及78.20±16.02对比56.52±13.92毫秒,p<0.001)。ES组的室性和室上性早搏明显更频繁。研究组中有4例患者(14.8%)在24小时动态心电图监测期间发生快速心律失常。
在我们的研究中,发现ES患儿的P波离散度和QT离散度比健康对照受试者更大。