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2型无症状长QT综合征患者心动周期和QT间期变异性的时间、频率及信息域分析

Time, frequency and information domain analysis of heart period and QT variability in asymptomatic long QT syndrome type 2 patients.

作者信息

Bari Vlasta, Girardengo Giulia, Marchi Andrea, De Maria Beatrice, Brink Paul A, Crotti Lia, Schwartz Peter J, Porta Alberto

出版信息

Annu Int Conf IEEE Eng Med Biol Soc. 2015;2015:294-7. doi: 10.1109/EMBC.2015.7318358.

Abstract

This study was designed to characterize in time, frequency and information domains heart period (HP) and QT interval variabilities in asymptomatic (ASYMP) long QT syndrome type 2 (LQT2) subjects. HP, approximated as the temporal distance between two consecutive R-wave peaks, and QT, approximated as the temporal distance between the R-wave peak and the T-wave offset, were automatically derived from 24h Holter recordings in 10 ASYMP LQT2 patients and 13 healthy non mutation carriers (NMC) subjects. All analyses were carried out during DAY (from 2 to 6 PM) and NIGHT (from 12 to 4 AM). Mean, variance, spectral power and complexity indices at short, medium and long time scales were assessed over HP and QT beat-to-beat series. Circadian rhythmicity was evident in both NMC and ASYMP LQT2 but ASYMP LQT2 subjects were characterized by higher HP, QT interval and HP variability during both DAY and NIGHT. In addition, multiscale complexity analysis was able to differentiate the groups by showing a higher HP complexity and a lower QT complexity at long time scales in ASYMP LQT2 during DAY. ASYMP LQT2 exhibited a different autonomic control compared to NMC and such a differentiation could be protective and assure them a lower risk profile.

摘要

本研究旨在从时间、频率和信息域三个方面,对无症状的2型长QT综合征(LQT2)患者的心动周期(HP)和QT间期变异性进行特征分析。HP近似为两个连续R波峰之间的时间间隔,QT近似为R波峰与T波终点之间的时间间隔,这些数据自动取自10例无症状LQT2患者和13例健康非突变携带者(NMC)的24小时动态心电图记录。所有分析均在白天(下午2点至6点)和夜间(凌晨12点至4点)进行。对HP和QT逐搏序列在短、中、长时间尺度上的均值、方差、频谱功率和复杂度指数进行了评估。NMC和无症状LQT2患者均存在昼夜节律,但无症状LQT2患者在白天和夜间的HP、QT间期及HP变异性均较高。此外,多尺度复杂度分析能够区分这两组患者,表现为无症状LQT2患者在白天长时间尺度上具有较高的HP复杂度和较低的QT复杂度。与NMC相比,无症状LQT2患者表现出不同的自主神经控制,这种差异可能具有保护作用,并确保他们具有较低的风险状况。

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