Ghio Stefano, Turco Annalisa, Klersy Catherine, Scelsi Laura, Raineri Claudia, Crescio Valeria, Viscardi Arianna, Grazioli Valentina, Sciortino Antonio, Oltrona Visconti Luigi, D'Armini Andrea Maria
Division of Cardiology, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
Division of Cardiology, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy.
J Electrocardiol. 2016 Mar-Apr;49(2):223-30. doi: 10.1016/j.jelectrocard.2015.12.006. Epub 2015 Dec 23.
The aim of the present study was to evaluate the changes of electrocardiographic (ECG) markers of right ventricular (RV) hypertrophy/overload in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary endarterectomy (PEA).
We evaluated 99 CTEPH patients who underwent PEA. P wave amplitude in DII, R wave amplitude in V1 and the number of patients with negative T wave in V1-V3 decreased significantly at 1month after surgery with no further change at 1year, in parallel with the rapid improvement in right heart hemodynamics. S wave amplitude in V1, R:S wave ratio in lead V6 and prevalence of SIQIII pattern improved significantly at 1year, in parallel with the progressive reverse remodeling of the right ventricle at echocardiography.
The study shows that some of the ECG markers of RV hypertrophy/overload better reflect RV hemodynamic overload while others better reflect the pathologic remodeling of the right ventricle.
本研究旨在评估接受肺动脉内膜剥脱术（PEA）的慢性血栓栓塞性肺动脉高压（CTEPH）患者右心室（RV）肥厚/负荷过重的心电图（ECG）标志物变化。
我们评估了99例接受PEA的CTEPH患者。术后1个月时，II导联P波振幅、V1导联R波振幅以及V1-V3导联T波倒置患者数量显著降低，1年时无进一步变化，同时右心血流动力学迅速改善。V1导联S波振幅、V6导联R:S波比值以及SIQIII图形发生率在1年时显著改善，同时超声心动图显示右心室逐渐发生逆向重构。
该研究表明，RV肥厚/负荷过重的一些ECG标志物能更好地反映RV血流动力学负荷，而另一些则能更好地反映右心室的病理重构。
