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短QT综合征中短不应期的缩短

Shortening of the Short Refractory Periods in Short QT Syndrome.

作者信息

Rollin Anne, Gandjbakhch Estelle, Giustetto Carla, Scrocco Chiara, Fourcade Carole, Monteil Benjamin, Mondoly Pierre, Cardin Christelle, Maupain Carole, Gaita Fiorenzo, Maury Philippe

机构信息

University Hospital Rangueil, Toulouse, France.

University Hospital La Pitié Salpétrière, Paris, France.

出版信息

J Am Heart Assoc. 2017 May 31;6(6):e005684. doi: 10.1161/JAHA.117.005684.

DOI:10.1161/JAHA.117.005684
PMID:28566296
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5669178/
Abstract

BACKGROUND

Diagnosis of short QT syndrome (SQTS) remains difficult in case of borderline QT values as often found in normal populations. Whether some shortening of refractory periods (RP) may help in differentiating SQTS from normal subjects is unknown.

METHODS AND RESULTS

Atrial and right ventricular RP at the apex and right ventricular outflow tract as determined during standard electrophysiological study were compared between 16 SQTS patients (QTc 324±24 ms) and 15 controls with similar clinical characteristics (QTc 417±32 ms). Atrial RP were significantly shorter in SQTS compared with controls at 600- and 500-ms basic cycle lengths. Baseline ventricular RP were significantly shorter in SQTS patients than in controls, both at the apex and right ventricular outflow tract and for any cycle length. Differences remained significant for RP of any subsequent extrastimulus at any cycle length and any pacing site. A cut-off value of baseline RP <200 ms at the right ventricular outflow tract either at 600- or 500-ms cycle length had a sensitivity of 86% and a specificity of 100% for the diagnosis of SQTS.

CONCLUSIONS

Patients with SQTS have shorter ventricular RP than controls, both at baseline during various cycle lengths and after premature extrastimuli. A cut-off value of 200 ms at the right ventricular outflow tract during 600- and 500-ms basic cycle length may help in detecting true SQTS from normal subjects with borderline QT values.

摘要

背景

在正常人群中常见的临界QT值情况下，短QT综合征（SQTS）的诊断仍然困难。难治期（RP）的一些缩短是否有助于将SQTS与正常受试者区分开来尚不清楚。

方法与结果

在标准电生理研究期间，比较了16例SQTS患者（QTc 324±24毫秒）和15例具有相似临床特征的对照者（QTc 417±32毫秒）的心尖部和右心室流出道的心房和右心室RP。在600毫秒和500毫秒的基础周期长度下，SQTS患者的心房RP明显短于对照者。无论是在心尖部还是右心室流出道，以及任何周期长度下，SQTS患者的基线心室RP均明显短于对照者。在任何周期长度和任何起搏部位，任何后续额外刺激的RP差异均保持显著。在600毫秒或500毫秒周期长度下，右心室流出道基线RP<200毫秒的截断值对SQTS诊断的敏感性为86%，特异性为100%。

结论

SQTS患者在不同周期长度的基线以及过早额外刺激后，其心室RP均短于对照者。在600毫秒和500毫秒基础周期长度下，右心室流出道200毫秒的截断值可能有助于从临界QT值的正常受试者中检测出真正的SQTS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/41334a8f00e2/JAH3-6-e005684-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/5e4a9124daeb/JAH3-6-e005684-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/d54854576c15/JAH3-6-e005684-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/f86eaa41a8d2/JAH3-6-e005684-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/8e6613e96850/JAH3-6-e005684-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/979acf266737/JAH3-6-e005684-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/2fe8f7ee4307/JAH3-6-e005684-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/41334a8f00e2/JAH3-6-e005684-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/5e4a9124daeb/JAH3-6-e005684-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/d54854576c15/JAH3-6-e005684-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/f86eaa41a8d2/JAH3-6-e005684-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/8e6613e96850/JAH3-6-e005684-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/979acf266737/JAH3-6-e005684-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/2fe8f7ee4307/JAH3-6-e005684-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0567/5669178/41334a8f00e2/JAH3-6-e005684-g007.jpg

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