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不同 QTc 公式校正对短 QT 间期检出率的影响及其对短 QT 综合征的发生概率和诊断的影响。

Impact of QTc formulae in the prevalence of short corrected QT interval and impact on probability and diagnosis of short QT syndrome.

机构信息

Barts Heart Centre, Barts Health NHS Trust, London, UK.

Farr Institute of Health Informatics, University College of London, London, UK.

出版信息

Heart. 2018 Mar;104(6):502-508. doi: 10.1136/heartjnl-2017-311673. Epub 2017 Sep 27.

Abstract

OBJECTIVE

To assess the prevalence of short corrected QT (QTc) intervals and its impact on short QT syndrome (SQTS) diagnosis using different QT correction formulae.

METHODS

Observational study. The prevalence of short QTc intervals was estimated using four different QT correction formulae in 14 662 young adults from the 'Sudden Cardiac Death Screening of Risk FactOrS' (SCD-SOS) cohort. Then, using data from this cohort and the pooled-cohort analysed by Gollob , comprising 61 patients with SQTS, we assessed the impact of the different QTc correction formulae on SQTS probability and diagnosis based on the Expert Consensus recommendations (QTc ≤330 ms or QTc 330-360 ms+1 additional risk feature).

RESULTS

The prevalence of individuals with a QTc ≤330 and ≤320 ms in the SCD-SOS cohort was extremely low (≤0.07% and≤0.02%, respectively), and these were more frequently identified by the Framingham correction. The different QTc correction formulae led to a shift in SQTS probability in 5%-10% of individuals in both the SCD-SOS and Gollob cohort). Intermediate probability individuals were rare (<0.1%), and no high-SQTS probability individuals were identified in the SCD-SOS cohort. Based on Consensus criteria, instead of 12 (0.08%) individuals being diagnosed with SQTS using the equation, a different number of individuals would meet diagnostic criteria with the other formulae: 11 (0.08%) using , 9 (0.06%) with and 16 (0.11%) using the equation.

CONCLUSION

Prevalence of SQTS in the apparently healthy adult population is low. Applying different QTc correction formulae leads to significant reclassification of SQTS probability and their impact on predicting outcomes should be assessed.

摘要

目的

使用不同的 QT 校正公式评估短校正 QT(QTc)间期的发生率及其对短 QT 综合征(SQTS)诊断的影响。

方法

观察性研究。在来自“猝死危险因素筛查”(SCD-SOS)队列的 14662 名年轻成年人中,使用四种不同的 QT 校正公式估计短 QTc 间期的发生率。然后,使用来自该队列的数据和 Gollob 汇总队列分析的数据,包括 61 名 SQTS 患者,我们根据专家共识建议(QTc≤330ms 或 QTc330-360ms+1 个额外风险特征)评估不同 QTc 校正公式对 SQTS 概率和诊断的影响。

结果

在 SCD-SOS 队列中,QTc≤330ms 和 QTc≤320ms 的个体发生率极低(分别为≤0.07%和≤0.02%),且这些个体更常由 Framingham 校正法识别。不同的 QTc 校正公式导致 SQTS 概率在 SCD-SOS 和 Gollob 队列中的 5%-10%个体中发生转移。中间概率个体很少(<0.1%),在 SCD-SOS 队列中未发现高 SQTS 概率个体。根据共识标准,使用 方程,12 名(0.08%)个体被诊断为 SQTS,而使用其他公式,会有不同数量的个体符合诊断标准:11 名(0.08%)使用 ,9 名(0.06%)使用 ,16 名(0.11%)使用 方程。

结论

在健康的成年人群中,SQTS 的发病率较低。应用不同的 QTc 校正公式会导致 SQTS 概率的显著重新分类,应评估其对预测结果的影响。

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