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经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者再灌注成功与T波峰至T波终末间期关系的评估

Assessment of the relationship between reperfusion success and T-peak to T-end interval in patients with ST elevation myocardial infarction treated with percutaneous coronary intervention.

作者信息

Çağdaş Metin, Karakoyun Süleyman, Rencüzoğulları İbrahim, Karabağ Yavuz, Yesin Mahmut, Velibey Yalçın, Artaç İnanç, İliş Doğan, Efe Süleyman Çağan, Taşar Onur, Tanboğa Halil İbrahim

机构信息

Department of Cardiology, Faculty of Medicine, Kafkas University; Kars-Turkey.

出版信息

Anatol J Cardiol. 2018 Jan;19(1):50-57. doi: 10.14744/AnatolJCardiol.2017.7949.

Abstract

OBJECTIVE

T-peak-T-end (TPE) interval, which represents the dispersion of repolarization, is defined as the interval between the peak and end of the T-wave, and is associated with increased malignant ventricular arrhythmia and sudden cardiac death (SCD) in patients with ST elevation myocardial infarction (STEMI). Although prolonged TPE interval is associated with poor short- and long-term outcomes, even in patients with STEMI treated with successful primary percutaneous coronary intervention (pPCI), clinical, angiographic, and laboratory parameters that affect TPE remain to be elucidated. The aim of our study was to evaluate the potential relationship between prolonged TPE interval and reperfusion success using ST segment resolution (STR) in patients with STEMI undergoing pPCI.

METHODS

In the current study, 218 consecutive patients with STEMI who underwent pPCI were enrolled; after exclusion, 164 patients were included in the study population.

RESULTS

Patients were divided into two groups according to the presence of complete (STR%≥70) or incomplete (STR%<70) STR. Preprocedural corrected TPE (cTPEPRE;116±21 ms vs. 108±21 ms; p=0.027), postprocedural TPE (TPEPOST; 107±16 ms vs. 92±21 ms; p<0.001), and postprocedural cTPE (cTPEPOST; 119±19 ms vs. 102±17 ms; p<0.001) intervals were significantly longer in patients with incomplete STR than in patients with complete STR, whereas there was no statistically significant difference between the two groups in terms of pre- and postprocedural and corrected QT intervals. cTPEPRE and cTPEPOST were found to be independent predictors for incomplete STR.

CONCLUSION

To our knowledge, this is the first study that evaluated the relationship between TPE interval and no-reflow defined by STR in patients with STEMI who were treated with pPCI.

摘要

目的

T峰-T末(TPE)间期代表复极离散度,定义为T波峰顶与终点之间的间期,与ST段抬高型心肌梗死(STEMI)患者恶性室性心律失常及心源性猝死(SCD)风险增加相关。尽管TPE间期延长与短期和长期不良预后相关,即便在接受成功的直接经皮冠状动脉介入治疗(pPCI)的STEMI患者中,影响TPE的临床、血管造影及实验室参数仍有待阐明。我们研究的目的是评估接受pPCI的STEMI患者中,TPE间期延长与采用ST段回落(STR)评估的再灌注成功之间的潜在关系。

方法

在本研究中,连续纳入218例接受pPCI的STEMI患者;排除后,164例患者纳入研究人群。

结果

根据是否存在完全性(STR%≥70)或不完全性(STR%<70)STR将患者分为两组。不完全性STR患者的术前校正TPE(cTPEPRE;116±21毫秒对108±21毫秒;p=0.027)、术后TPE(TPEPOST;107±16毫秒对92±21毫秒;p<0.001)及术后校正TPE(cTPEPOST;119±19毫秒对102±17毫秒;p<0.001)间期显著长于完全性STR患者,而两组术前、术后及校正QT间期无统计学显著差异。发现cTPEPRE和cTPEPOST是不完全性STR的独立预测因素。

结论

据我们所知,这是第一项评估接受pPCI治疗的STEMI患者中TPE间期与由STR定义的无复流之间关系的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a8c/5864790/a5641dc2c093/AJC-19-50-g001.jpg

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