Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Çamlık Street, Trabzon 61040, Turkey.
Department of Cardiology, Kafkas University Hospital, Kars, Turkey.
J Geriatr Cardiol. 2014 Dec;11(4):286-90. doi: 10.11909/j.issn.1671-5411.2014.04.002.
QT dispersion (QTd) is a predictor of ventricular arrhythmia. Ventricular arrhythmia is an important factor influencing morbidity and mortality in patients with aortic stenosis. Surgical aortic valve replacement reduced the QTd in this patients group. However, the effect of transcatheter aortic valve implantation (TAVI) on QTd in patients with aortic stenosis is unknown. The aim of this study was to investigate the effect of TAVI on QTd in patients with aortic stenosis.
Patients with severe aortic stenosis, who were not candidates for surgical aortic valve replacement due to contraindications or high surgical risk, were included in the study. All patients underwent electrocardiographic and echocardiographic evaluation before, and at the 6(th) month after TAVI, computed QTd and left ventricular mass index (LVMI).
A total 30 patients were admitted to the study (mean age 83.2 ± 1.0 years, female 21 and male 9, mean valve area 0.7 ± 3 mm(2)). Edwards SAPIEN heart valves, 23 mm (21 patients) and 26 mm (9 patients), by the transfemoral approach were used in the TAVI procedures. All TAVI procedures were successful. Both QTd and LVMI at the 6(th) month after TAVI were significantly reduced compared with baseline values of QTd and LVMI before TAVI (73.8 ± 4 ms vs. 68 ± 2 ms, P = 0.001 and 198 ± 51 g/m(2) vs. 184 ± 40 g/m(2), P = 0.04, respectively). There was a significant correlation between QTd and LVMI (r = 0.646, P < 0.001).
QTd, which malign ventricular arrhythmia marker, and LVMI were significantly reduced after TAVI procedure. TAVI may decrease the possibility of ventricular arrhythmia in patients with aortic stenosis.
QT 离散度（QTd）是预测室性心律失常的指标。室性心律失常是影响主动脉瓣狭窄患者发病率和死亡率的重要因素。主动脉瓣置换术降低了该患者群体的 QTd。然而，经导管主动脉瓣植入术（TAVI）对主动脉瓣狭窄患者的 QTd 影响尚不清楚。本研究旨在探讨 TAVI 对主动脉瓣狭窄患者 QTd 的影响。
纳入因禁忌症或高手术风险而不适合行主动脉瓣置换术的严重主动脉瓣狭窄患者。所有患者均在 TAVI 前及术后 6 个月行心电图和超声心动图评估，计算 QTd 和左心室质量指数（LVMI）。
共纳入 30 例患者（平均年龄 83.2 ± 1.0 岁，女性 21 例，男性 9 例，平均瓣口面积 0.7 ± 3 mm²）。TAVI 采用经股动脉入路，使用 Edwards SAPIEN 心脏瓣膜，23 mm（21 例）和 26 mm（9 例）。所有 TAVI 均成功完成。与 TAVI 前的 QTd 和 LVMI 相比，术后 6 个月的 QTd 和 LVMI 均显著降低（73.8 ± 4 ms 比 68 ± 2 ms，P = 0.001；198 ± 51 g/m² 比 184 ± 40 g/m²，P = 0.04）。QTd 与 LVMI 呈显著相关（r = 0.646，P < 0.001）。
TAVI 术后 QTd 和 LVMI 明显降低，QTd 是恶性室性心律失常的标志物。TAVI 可能降低主动脉瓣狭窄患者发生室性心律失常的可能性。
