Lutfi Mohamed F
Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University Khartoum, Sudan.
Front Physiol. 2016 Sep 21;7:422. doi: 10.3389/fphys.2016.00422. eCollection 2016.
Previous studies assessing effect of ischemia on ventricular repolarization are mostly directed toward patients with coronary artery disease (CAD); however, similar reports on cardiac syndrome X (CSX) are scarce. Whether microvascular dysfunction of CSX and ischemia induced by CAD produce comparable effect on ventricular repolarization is unclear and deserve further studies. In the present study, ECG measures of ventricular repolarization were compared between CAD and CSX patients (40 subjects in each group). Following evaluation of sociodemographic characteristics, medical and past medical history, a resting ECG was used to assess measurements of ventricular repolarization in each patient, namely, QT interval (QT), corrected QT interval (QTc), QT dispersion (QTd), corrected QT dispersion (QTcd), adjacent QT dispersion (AdQTd), QT dispersion ratio (QTdR), JT dispersion (JTd), and Corrected JT dispersion (JTcd). Results showed comparable QT intervals and QTd in CAD and CSX patients even after adjustment for the possible variations in gender, age and body mass index of the studied groups. Although JTd was increased in CSX subjects (26.6 ± 7.2 ms) compared with CAD patients (22.7 ± 6.5 ms, = 0.019), statistical significance disappeared after correcting JT for variations in heart rate. QT and QTc were significantly below 440 ms in CAD as well as CSX patients ( < 0.001). In contrast, maximum QTd, maximum QTcd and AdQTd of CAD and CSX patients were significantly above 440 ms ( < 0.001). The means of JTd and JTcd were significantly above 22 ms and 24 ms respectively ( < 0.001, = 0.001) in CSX but not CAD patients ( = 0.529, = 0.281). The present findings clearly demonstrate comparable measures of ventricular repolarization in CAD and CSX patients and consequently an equal risk of cardiac events in both groups.
以往评估缺血对心室复极影响的研究大多针对冠状动脉疾病(CAD)患者;然而,关于心脏X综合征(CSX)的类似报道却很少。CSX的微血管功能障碍和CAD引起的缺血对心室复极是否产生类似影响尚不清楚,值得进一步研究。在本研究中,对CAD患者和CSX患者(每组40名受试者)的心室复极心电图指标进行了比较。在评估社会人口统计学特征、病史和既往病史后,使用静息心电图评估每位患者的心室复极测量值,即QT间期(QT)、校正QT间期(QTc)、QT离散度(QTd)、校正QT离散度(QTcd)、相邻QT离散度(AdQTd)、QT离散度比值(QTdR)、JT离散度(JTd)和校正JT离散度(JTcd)。结果显示,即使对研究组的性别、年龄和体重指数的可能差异进行校正后,CAD患者和CSX患者的QT间期和QTd仍具有可比性。尽管与CAD患者(22.7±6.5毫秒)相比,CSX受试者的JTd增加(26.6±7.2毫秒,P = 0.019),但在对心率变化校正JT后,统计学显著性消失。CAD患者和CSX患者的QT和QTc均显著低于440毫秒(P<0.001)。相比之下,CAD患者和CSX患者的最大QTd、最大QTcd和AdQTd均显著高于440毫秒(P<0.001)。CSX患者的JTd和JTcd平均值分别显著高于22毫秒和24毫秒(P<0.001,P = 0.001),而CAD患者则不然(P = 0.529,P = 0.281)。目前的研究结果清楚地表明,CAD患者和CSX患者的心室复极指标具有可比性,因此两组发生心脏事件的风险相等。