1型与非1型Brugada综合征患者传导和复极化离散度更高：一项单中心心电图研究
Higher Dispersion Measures of Conduction and Repolarization in Type 1 Compared to Non-type 1 Brugada Syndrome Patients: An Electrocardiographic Study From a Single Center.
作者信息
Tse Gary, Li Ka Hou Christien, Li Guangping, Liu Tong, Bazoukis George, Wong Wing Tak, Chan Matthew T V, Wong Martin C S, Xia Yunlong, Letsas Konstantinos P, Chan Gary Chin Pang, Chan Yat Sun, Wu William K K
机构信息
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.
出版信息
Front Cardiovasc Med. 2018 Oct 4;5:132. doi: 10.3389/fcvm.2018.00132. eCollection 2018.
Brugada syndrome (BrS) is a cardiac ion channelopathy that predisposes affected individuals to sudden cardiac death (SCD). Type 1 BrS is thought to take a more malignant clinical course than non-type 1 BrS. We hypothesized that the degrees of abnormal repolarization and conduction are greater in type 1 subjects and these differences can be detected by electrocardiography (ECG). Electrocardiographic data from spontaneous type 1 and non-type 1 BrS patients were analyzed. ECG parameters were measured from leads V1 to V3. Values were expressed as median [lower quartile-upper quartile] and compared using Kruskal-Wallis ANOVA. Compared to non-type 1 BrS patients ( = 29), patients with spontaneous type 1 patterns ( = 22) showed similar ( > 0.05) heart rate (73 [64-77] vs. 68 [62-80] bpm), QRS duration (136 [124-161] vs. 127 [117-144] ms), uncorrected QT (418 [393-443] vs. 402 [386-424] ms) and corrected QT intervals (457 [414-474] vs. 430 [417-457] ms), JT intervals (174 [144-183] vs. 174 [150-188] ms), T T intervals (101 [93-120] vs. 99 [90-105] ms), T T/QT ratios (0.25 [0.23-0.27] vs. 0.24 [0.22-0.27]), T T/QRS (0.77 [0.62-0.87] vs. 0.77 [0.69-0.86]), T T/(QRS × QT) (0.00074 [0.00034-0.00096] vs. 0.00073 [0.00048-0.00012] ms), index of Cardiac Electrophysiological Balance (iCEB, QT/QRS, marker of wavelength: 3.14 [2.56-3.35] vs. 3.21 [2.85-3.46]) and corrected iCEB (QTc/QRS: 3.25 [2.91-3.73] vs. 3.49 [2.99-3.78]). Higher QRS dispersion was seen in type 1 subjects (QRSd: 34 [24-66] vs. 24 [12-34] ms) but QT dispersion (QTd: 48 [39-71] vs. 43 [22-94] ms), QTc dispersion (QTcd: 52 [41-79] vs. 46 [23-104] ms), JT dispersion (44 [23-62] vs. 45 [30-62] ms), T T dispersion (28 [15-34] vs. 29 [22-53] ms) or T T/QT dispersion (0.06 [0.03-0.08] vs. 0.08 [0.04-0.12]) did not differ between the two groups. Type 1 subjects showed higher (QRSd × T T)/QRS (25 [19-44] vs. 19 [9-30] ms) but similar iCEB dispersion (0.83 [0.49-1.14] vs. 0.61 [0.34-0.92]) and iCEBc dispersion (0.93 [0.51-1.15] vs. 0.65 [0.39-0.96]). Higher levels of dispersion in conduction and repolarization are found in type 1 than non-type 1 BrS patients, potentially explaining the higher incidence of ventricular arrhythmias in the former group.
Brugada综合征（BrS）是一种心脏离子通道病，使受影响个体易发生心源性猝死（SCD）。1型BrS被认为比非1型BrS具有更恶性的临床病程。我们假设1型患者的复极和传导异常程度更大，并且这些差异可通过心电图（ECG）检测到。对1型和非1型自发性BrS患者的心电图数据进行了分析。从V1至V3导联测量心电图参数。数值以中位数[下四分位数 - 上四分位数]表示，并使用Kruskal - Wallis方差分析进行比较。与非1型BrS患者（n = 29）相比，1型自发性心电图模式患者（n = 22）的心率（73 [64 - 77] 次/分钟 vs. 68 [62 - 80] 次/分钟）、QRS时限（136 [124 - 161] 毫秒 vs. 127 [117 - 144] 毫秒）、未校正QT（418 [393 - 443] 毫秒 vs. 402 [386 - 424] 毫秒）和校正QT间期（457 [414 - 474] 毫秒 vs. 430 [417 - 457] 毫秒）、JT间期（174 [144 - 183] 毫秒 vs. 174 [150 - 188] 毫秒）、T波峰 - 末间期（101 [93 - 120] 毫秒 vs. 99 [90 - 105] 毫秒）、T波峰 - 末间期/QT比值（0.25 [0.23 - 0.27] vs. 0.24 [0.22 - 0.27]）、T波峰 - 末间期/QRS（0.77 [0.62 - 0.8] 7 vs. 0.77 [0.69 - 0.86]）、T波峰 - 末间期/（QRS×QT）（0.00074 [0.00034 - 0.0] 0096 vs. 0.00073 [0.00048 - 0.00012] 毫秒）、心脏电生理平衡指数（iCEB，QT/QRS，波长标志物：3.14 [ ] 2.56 - 3.35 vs. 3.21 [2.85 - 3.46]）和校正iCEB（QTc/QRS：3.25 [2.91 - 3.73] vs. 3.49 [2.99 - 3.78]）相似（P>0.05）。1型患者的QRS离散度更高（QRSd：34 [24 - 66] 毫秒 vs. 24 [12 - 34] 毫秒），但两组间的QT离散度（QTd：48 [39 - 71] 毫秒 vs. 43 [22 - 94] 毫秒）、QTc离散度（QTcd：52 [41 - 79] 毫秒 vs. 46 [23 - 104] 毫秒）、JT离散度（44 [23 - 62] 毫秒 vs. 45 [30 - 62] 毫秒）、T波峰 - 末间期离散度（28 [15 - 34] 毫秒 vs. 29 [22 - 53] 毫秒）或T波峰 - 末间期/QT离散度（0.06 [0.03 - 0.08] vs. 0.08 [0.04 - 0.12]）无差异。1型患者的（QRSd×T波峰 - 末间期）/QRS更高（25 [19 - 44] 毫秒 vs. 19 [9 - 30] 毫秒），但iCEB离散度（0.83 [0.49 - 1.14] vs. 0.61 [0.34 - 0.92]）和iCEBc离散度（（0.93 [0.51 - 1.15] vs. 0.65 [0.39 - 0.96]）相似。与非1型BrS患者相比，1型患者的传导和复极离散度更高，这可能解释了前一组室性心律失常发生率较高的原因。
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