药物诱导尖端扭转型室性心动过速史与 T 波形态异常相关。
A History of Drug-Induced Torsades de Pointes Is Associated With T-wave Morphological Abnormalities.
机构信息
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
Laboratory of Experimental Cardiology, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
出版信息
Clin Pharmacol Ther. 2018 Jun;103(6):1100-1106. doi: 10.1002/cpt.886. Epub 2017 Oct 25.
The hypothesis of the study is that Torsades de pointes (TdP) history can be better identified using T-wave morphology compared to Fridericia-corrected QT interval (QTcF) at baseline. ECGs were recorded at baseline and during sotalol challenge in 20 patients with a history of TdP (+TdP) and 16 patients without previous TdP (-TdP). The QTcF and T-wave morphology combination score (MCS) were calculated. At baseline, there was no significant difference in QTcF between the groups (+TdP: QTcF = 446 ± 9 ms; -TdP: QTcF = 431 ± 9 ms, P = 0.27). In contrast, MCS was significantly different between the groups at baseline (+TdP: MCS = 1.07 ± 0.095; -TdP: MCS = 0.74 ± 0.07, P = 0.012). Both QTcF and MCS could be used to discriminate between +TdP and -TdP after sotalol but only MCS reached statistical significance at baseline. Combining QTcF with MCS provided a significantly larger difference between groups than QTcF alone.
该研究的假设是，与基础 Fridericia 校正 QT 间期（QTcF）相比，使用 T 波形态可以更好地识别尖端扭转型室性心动过速（TdP）病史。在 20 例有 TdP 病史（+TdP）的患者和 16 例无先前 TdP 病史（-TdP）的患者中，在基线和索他洛尔挑战期间记录心电图。计算 QTcF 和 T 波形态组合评分（MCS）。在基线时，两组之间 QTcF 无显著差异（+TdP：QTcF=446±9ms；-TdP：QTcF=431±9ms，P=0.27）。相比之下，基线时两组之间的 MCS 差异显著（+TdP：MCS=1.07±0.095；-TdP：MCS=0.74±0.07，P=0.012）。索他洛尔后，无论是 QTcF 还是 MCS 都可用于区分+TdP 和-TdP，但仅 MCS 在基线时具有统计学意义。与单独使用 QTcF 相比，将 QTcF 与 MCS 相结合可使组间差异显著增大。
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