Braschi Annabella, Abrignani Maurizio G, Francavilla Vincenzo C, Abrignani Vincenzo, Francavilla Giuseppe
Department of Internal and Specialistic Medicine, Palermo University Hospital, Palermo, Italy.
Operative Unit of Cardiology, S. Antonio Abate Hospital, Trapani, Italy.
Int J Clin Pract. 2017 May;71(5). doi: 10.1111/ijcp.12949.
Some electrocardiographic parameters are able to assess indirectly ventricular repolarisation homogeneity. It is consequently essential to discriminate between normal and abnormal values in clinical decision-making. Considering there is still not a consensus about normal cut-off values, the aim of this study was to document reference intervals in all age groups of a healthy population, providing for age- and sex-percentile tables, which can be used easily and quickly in clinical practice.
We evaluated repolarisation markers in 606 sex-matched participants aged 1 day-94 years. Each subject underwent a 12-lead electrocardiogram at rest, and the following parameters were measured: QT, corrected QT, QTpeak, Tpeak-Tend, Tpeak-Tend dispersion, Tpeak-Tend/QT and QTpeak/QT ratio.
A relationship was demonstrated between age and QTpeak, Tpeak-Tend, QT and QTc. In children, QTpeak, Tpeak-Tend and QT intervals increased linearly with age. In adolescents, all the three parameters remained stable. In adults, QTpeak and QT showed a further significant increase. On the contrary, Tpeak-Tend interval was longer in adults aged between 20 and 64 years than in participants aged 65 years or over, but the difference was not statistically significant. Male vs female participants showed longer Tpeak-Tend intervals; this sex difference was not statistically significant at birth and during childhood, whereas it was in adolescents and in adults.
Repolarisation parameters showed age- and sex-based variations, which are important to know to differentiate normal from pathological values.
一些心电图参数能够间接评估心室复极的均匀性。因此，在临床决策中区分正常和异常值至关重要。鉴于目前对于正常临界值仍未达成共识，本研究的目的是记录健康人群所有年龄组的参考区间，提供年龄和性别百分位数表，以便在临床实践中能够轻松快速地使用。
我们评估了606名年龄在1天至94岁之间、性别匹配的参与者的复极标志物。每位受试者静息时接受12导联心电图检查，并测量以下参数：QT间期、校正QT间期、QTpeak、Tpeak-Tend间期、Tpeak-Tend离散度、Tpeak-Tend/QT比值以及QTpeak/QT比值。
QTpeak、Tpeak-Tend、QT间期和校正QT间期与年龄之间存在关联。在儿童中，QTpeak、Tpeak-Tend和QT间期随年龄呈线性增加。在青少年中，这三个参数均保持稳定。在成年人中，QTpeak和QT间期进一步显著增加。相反，20至64岁成年人的Tpeak-Tend间期比65岁及以上参与者的更长，但差异无统计学意义。男性参与者的Tpeak-Tend间期长于女性；这种性别差异在出生时和儿童期无统计学意义，而在青少年和成年人中有统计学意义。
复极参数呈现出基于年龄和性别的变化，了解这些变化对于区分正常和病理值很重要。
