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即使在没有心电图诊断为左心室肥厚的受试者中,校正QT间期延长也可预测未来的中风事件。

Prolonged corrected QT interval is predictive of future stroke events even in subjects without ECG-diagnosed left ventricular hypertrophy.

作者信息

Ishikawa Joji, Ishikawa Shizukiyo, Kario Kazuomi

机构信息

From the Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan (J.I., K.K.); and Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Japan (S.I.).

出版信息

Hypertension. 2015 Mar;65(3):554-60. doi: 10.1161/HYPERTENSIONAHA.114.04722. Epub 2014 Dec 22.

Abstract

We attempted to evaluate whether subjects who exhibit prolonged corrected QT (QTc) interval (≥440 ms in men and ≥460 ms in women) on ECG, with and without ECG-diagnosed left ventricular hypertrophy (ECG-LVH; Cornell product, ≥244 mV×ms), are at increased risk of stroke. Among the 10 643 subjects, there were a total of 375 stroke events during the follow-up period (128.7±28.1 months; 114 142 person-years). The subjects with prolonged QTc interval (hazard ratio, 2.13; 95% confidence interval, 1.22-3.73) had an increased risk of stroke even after adjustment for ECG-LVH (hazard ratio, 1.71; 95% confidence interval, 1.22-2.40). When we stratified the subjects into those with neither a prolonged QTc interval nor ECG-LVH, those with a prolonged QTc interval but without ECG-LVH, and those with ECG-LVH, multivariate-adjusted Cox proportional hazards analysis demonstrated that the subjects with prolonged QTc intervals but not ECG-LVH (1.2% of all subjects; incidence, 10.7%; hazard ratio, 2.70, 95% confidence interval, 1.48-4.94) and those with ECG-LVH (incidence, 7.9%; hazard ratio, 1.83; 95% confidence interval, 1.31-2.57) had an increased risk of stroke events, compared with those with neither a prolonged QTc interval nor ECG-LVH. In conclusion, prolonged QTc interval was associated with stroke risk even among patients without ECG-LVH in the general population.

摘要

我们试图评估心电图显示校正QT(QTc)间期延长(男性≥440毫秒,女性≥460毫秒)且伴有或不伴有心电图诊断的左心室肥厚(ECG-LVH;康奈尔乘积,≥244 mV×ms)的受试者是否中风风险增加。在10643名受试者中,随访期间共有375例中风事件(128.7±28.1个月;114142人年)。即使在校正ECG-LVH后,QTc间期延长的受试者(风险比,2.13;95%置信区间,1.22 - 3.73)中风风险仍增加(风险比,1.71;95%置信区间,1.22 - 2.40)。当我们将受试者分为既无QTc间期延长也无ECG-LVH、有QTc间期延长但无ECG-LVH以及有ECG-LVH三组时,多变量校正的Cox比例风险分析表明,有QTc间期延长但无ECG-LVH的受试者(占所有受试者的1.2%;发病率,10.7%;风险比,2.70,95%置信区间,1.48 - 4.94)和有ECG-LVH的受试者(发病率,7.9%;风险比,1.83;95%置信区间,1.31 - 2.57)与既无QTc间期延长也无ECG-LVH的受试者相比,中风事件风险增加。总之,在一般人群中,即使在无ECG-LVH的患者中,QTc间期延长也与中风风险相关。

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