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健康志愿者中心脏周期与QT间期的生理关系。

Physiologic relation between cardiac cycle and QT duration in healthy volunteers.

作者信息

Lecocq B, Lecocq V, Jaillon P

机构信息

Clinical Pharmacology Unit, St. Antoine University Hospital, Paris, France.

出版信息

Am J Cardiol. 1989 Sep 1;64(8):481-6. doi: 10.1016/0002-9149(89)90425-6.

Abstract

To determine the relation between QT duration and RR interval on the electrocardiogram, 2 studies were undertaken in 23 young healthy volunteers (mean age 24 years). In study 1, the electrocardiogram (paper speed at 50 mm/s, 800 measurements/subject) was recorded in 11 subjects (5 men, 6 women) at rest, during dynamic exercise and after rapid intravenous injections of isoproterenol (0.2 to 12.8 micrograms), before and after intravenous atropine (2 mg). In study 2, the QT-RR relation was studied at rest and during exercise in 12 subjects (6 men, 6 women) before and after oral propranolol (80 mg). The results confirmed a monoexponential individual relation of the QT and RR intervals during rest and exercise: QT = A-B.Exp (-k.RR). By pooling the RR-QT plots from the 11 subjects in study 1, we found that the measured QT interval = 425-676.Exp (-3.7.10(-3) RR. During isoproterenol-induced tachycardia, QT either did not change or increased and this may indicate an increase in temporal dispersion of ventricular repolarization. Atropine-induced tachycardia produced changes similar to those resulting from exercise testing. Propranolol did not change the QT-RR relation despite a lengthening in RR intervals. These results suggest that physiologic QT-RR adaptation is mainly under parasympathetic control.

摘要

为确定心电图上QT间期与RR间期的关系,对23名年轻健康志愿者(平均年龄24岁)进行了两项研究。在研究1中,对11名受试者(5名男性,6名女性)在静息状态、动态运动期间以及快速静脉注射异丙肾上腺素(0.2至12.8微克)前后、静脉注射阿托品(2毫克)前后进行了心电图记录(纸速50毫米/秒,每位受试者800次测量)。在研究2中,对12名受试者(6名男性,6名女性)在口服普萘洛尔(80毫克)前后的静息状态和运动期间的QT-RR关系进行了研究。结果证实了静息和运动期间QT与RR间期存在单指数个体关系:QT = A - B·Exp(-k·RR)。通过汇总研究1中11名受试者的RR-QT图,我们发现测量的QT间期 = 425 - 676·Exp(-3.7×10⁻³RR)。在异丙肾上腺素诱发的心动过速期间,QT要么不变要么增加,这可能表明心室复极的时间离散度增加。阿托品诱发的心动过速产生的变化与运动试验产生的变化相似。尽管RR间期延长,但普萘洛尔并未改变QT-RR关系。这些结果表明生理性QT-RR适应主要受副交感神经控制。

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