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非糖尿病ST段抬高型心肌梗死患者校正QT离散度与SYNTAX评分检测的冠状动脉疾病严重程度的相关性

Correlation of corrected QT dispersion with the severity of coronary artery disease detected by SYNTAX score in non-diabetic patients with STEMI.

作者信息

Helmy Hatem, Abdel-Galeel Ahmed, Taha Kishk Yehia, Mohammed Sleem Khaled

机构信息

Department of Cardiology, Assiut University, Egypt.

Assiut Policemen Hospital, Egypt.

出版信息

Egypt Heart J. 2017 Jun;69(2):111-117. doi: 10.1016/j.ehj.2016.12.001. Epub 2017 Jan 26.

Abstract

INTRODUCTION

Determination of the QT interval dispersion by means of a standard ECG at rest has been widely used for cardiovascular risk assessment during the last 15 years as one of the recent explanations for the development of life threatening ventricular arrhythmias. However, little is known about the relation between QT dispersion and the severity of coronary artery atherosclerosis as defined by SYNTAX score.

AIM OF WORK

The present study was done to assess the correlation between QTc dispersion and the severity of coronary artery disease in acute ST elevation myocardial infarction (STEMI) detected by SYNTAX score.

PATIENTS AND METHODS

It included 50 patients who were non-diabetic, non-hypertensive and diagnosed as acute STEMI within 6 months undergoing coronary angiography in the cath. lab. of Assiut University Hospital. QT dispersion was calculated as the difference between the longest (QT max) and the shortest QT (QTmin) interval recorded by standard 12 lead ECG. The QT interval was corrected by using Bazett's formula (QTc = QT/square root of R-R interval in seconds). Corrected QT dispersion (QTcd) was defined as the difference between the maximum and minimum QTc for a given heart rate. The SYNTAX score is calculated by syntax calculator, a new tool to grade the complexity of coronary artery disease.

RESULTS

Out of 50 participating patients, there were 43 (86%) males with mean age 53.9 ± 12.1 years. The mean QTc dispersion was 83.1 ± 20.3 ms, while mean SYNTAX score was 11.6 ± 6.1. There is a strong positive correlation between QTc dispersion and SYNTAX score. This was not related to age, gender, risk factors or family history of ischemic heart disease. Of note, there was a relationship between QTc dispersion and serum creatinine.

CONCLUSIONS

Our study concluded that there is a significant positive correlation between corrected QT dispersion and severity of coronary artery disease as assessed by SYNTAX score.

摘要

引言

在过去15年中,通过静息标准心电图测定QT间期离散度已被广泛用于心血管风险评估,这是对危及生命的室性心律失常发生的最新解释之一。然而,关于QT离散度与由SYNTAX评分定义的冠状动脉粥样硬化严重程度之间的关系,人们知之甚少。

工作目的

本研究旨在评估通过SYNTAX评分检测的急性ST段抬高型心肌梗死(STEMI)患者中QTc离散度与冠状动脉疾病严重程度之间的相关性。

患者和方法

研究纳入了50例非糖尿病、非高血压患者,这些患者在6个月内被诊断为急性STEMI,并在阿斯尤特大学医院心内科导管室接受冠状动脉造影。QT离散度通过标准12导联心电图记录的最长QT(QTmax)和最短QT(QTmin)间期之差来计算。QT间期采用Bazett公式进行校正(QTc = QT/√RR间期(秒))。校正后的QT离散度(QTcd)定义为给定心率下最大QTc与最小QTc之差。SYNTAX评分通过SYNTAX计算器计算得出,这是一种用于评估冠状动脉疾病复杂性的新工具。

结果

在50例参与研究的患者中,有43例(86%)为男性,平均年龄53.9±12.1岁。平均QTc离散度为83.1±20.3毫秒,而平均SYNTAX评分为11.6±6.1。QTc离散度与SYNTAX评分之间存在强正相关。这与年龄、性别、危险因素或缺血性心脏病家族史无关。值得注意的是,QTc离散度与血清肌酐之间存在关联。

结论

我们的研究得出结论,校正后的QT离散度与通过SYNTAX评分评估的冠状动脉疾病严重程度之间存在显著正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/628f/5839347/13c2106f7226/gr1.jpg

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