Tse Gary, Gong Mengqi, Meng Lei, Wong Cheuk Wai, Georgopoulos Stamatis, Bazoukis George, Wong Martin C S, Letsas Konstantinos P, Vassiliou Vassilios S, Xia Yunlong, Baranchuk Adrian M, Yan Gan-Xin, Liu Tong
Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China.
Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
J Electrocardiol. 2018 May-Jun;51(3):396-401. doi: 10.1016/j.jelectrocard.2018.03.001. Epub 2018 Mar 6.
Congenital long QT syndrome (LQTS) predisposes affected individuals to ventricular tachycardia/fibrillation (VF/VF), potentially resulting in sudden cardiac death. The T-T interval and the T-T/QT ratio, electrocardiographic markers of dispersion of ventricular repolarization, were proposed for risk stratification but their predictive values in LQTS have been controversial. A systematic review and meta-analysis was conducted to examine the value of T-T intervals and T-T/QT ratios in predicting arrhythmic and mortality outcomes in congenital LQTS.
PubMed and Embase databases were searched until 9th May 2017, identifying 199 studies.
Five studies on long QT syndrome were included in the final meta-analysis. T-T intervals were longer (mean difference [MD]: 13ms, standard error [SE]: 4ms, P=0.002; I=34%) in congenital LQTS patients with adverse events [syncope, ventricular arrhythmias or sudden cardiac death] compared to LQTS patients without such events. By contrast, T-T/QT ratios were not significantly different between the two groups (MD: 0.02, SE: 0.02, P=0.26; I=0%).
This meta-analysis showed that T-T interval is significant higher in individuals who are at elevated risk of adverse events in congenital LQTS, offering incremental value for risk stratification.
先天性长QT综合征（LQTS）使患者易发生室性心动过速/心室颤动（VT/VF），可能导致心源性猝死。T - T间期和T - T/QT比值作为心室复极离散度的心电图指标，被用于风险分层，但其在LQTS中的预测价值一直存在争议。本研究进行了一项系统评价和荟萃分析，以探讨T - T间期和T - T/QT比值在预测先天性LQTS心律失常和死亡结局中的价值。
检索PubMed和Embase数据库至2017年5月9日，共识别出199项研究。
最终的荟萃分析纳入了5项关于长QT综合征的研究。与无不良事件（晕厥、室性心律失常或心源性猝死）的LQTS患者相比，发生不良事件的先天性LQTS患者的T - T间期更长（平均差[MD]：13ms，标准误[SE]：4ms，P = 0.002；I² = 34%）。相比之下，两组间的T - T/QT比值无显著差异（MD：0.02，SE：0.02，P = 0.26；I² = 0%）。
该荟萃分析表明，先天性LQTS中发生不良事件风险较高的个体的T - T间期显著更长，为风险分层提供了额外价值。
