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射血分数保留、中度降低和重度降低的心力衰竭患者Tp-Te间期与Tp-Te/Qt比值的比较

Comparing of Tp-Te Interval and Tp-Te/Qt Ratio in Patients with Preserved, Mid-Range and Reduced Ejection Fraction Heart Failure.

作者信息

Son Osman, Boduroglu Yalcin

机构信息

Department of Endocrinology, Private Acibadem Hospital, Eskisehir, Turkey.

Department of Cardiology, Ahi Evran University Education and Research Hospital, Kirsehir, Turkey.

出版信息

Open Access Maced J Med Sci. 2019 Mar 13;7(5):752-759. doi: 10.3889/oamjms.2019.186. eCollection 2019 Mar 15.

Abstract

BACKGROUND

Heart failure (HF) is classified in three class: HF with preserved EF (HFpEF); normal or LVEF ≥ 50%, HF with reduced EF (HFrEF); LEVF < 40% and newly HF mid-range EF (HFmrEF); LVEF 40-49%. On Electrocardiography (ECG) T wave, Tpeak-Tend (Tp-Te) interval reflects transmural dispersion of repolarisation (TDR) which of these indexes have been proposed as predictors of risk for ventricular arrhythmia (VA) in many cardiac diseases.

AIM

Aim of this study to asses these indices of TDR among three HF class.

METHODS

Total of 192 patients were included in this study.

RESULTS

Many of indices like Tp-Te, Tp-Te/QT wasn't different between groups (P > 0.05). But mean Q-Tpeak (QTp), S-Tend (S-Te) and S-Tpeak (S-Tp) were found significantly different between groups (P < 0.05). Again S-Te was found different according to having fragmented QRS (fQRS) on ECG (P = 0.031). Comparing to mitral inflow E/A parameters showed significant differences for Tp-Te, Tp-Tec, Tp-Te/QT, Tp-Te/QTc and Tp-Tec/QTc parameters. Finally, we found correlations between S-Te and white blood cell (WBC) (r = - 0.171; P = 0.037) and S-Tp and WBC (r = - 0.170; P = 0.038) and between S-Te and fQRS (r = 0.158; P = 0.031).

CONCLUSIONS

We didn't find differences for many of indices of TDR like Tp-Te interval between groups except QTp, S-Te, S-Tp intervals. Also, S-Te and fQRS showed significant correlation. For prediction of ventricular arrhythmia and cardiovascular death newer indexes on ECG are needed to be established in the future which will make us facilitate to distinguish high risk patients.

摘要

背景

心力衰竭(HF)分为三类:射血分数保留的心力衰竭(HFpEF),左心室射血分数(LVEF)正常或≥50%;射血分数降低的心力衰竭(HFrEF),LVEF<40%;以及新定义的射血分数中间范围的心力衰竭(HFmrEF),LVEF为40 - 49%。在心电图(ECG)上,T波、T峰 - T末(Tp - Te)间期反映复极跨壁离散度(TDR),在许多心脏疾病中,这些指标已被提出作为室性心律失常(VA)风险的预测因子。

目的

本研究旨在评估这三类心力衰竭患者的TDR指标。

方法

本研究共纳入192例患者。

结果

Tp - Te、Tp - Te/QT等许多指标在各组之间无差异(P>0.05)。但平均Q - T峰(QTp)、S - T末(S - Te)和S - T峰(S - Tp)在各组之间存在显著差异(P<0.05)。此外,根据心电图上是否有碎裂QRS波(fQRS),S - Te也存在差异(P = 0.031)。与二尖瓣流入E/A参数比较,Tp - Te、Tp - Tec、Tp - Te/QT、Tp - Te/QTc和Tp - Tec/QTc参数显示出显著差异。最后,我们发现S - Te与白细胞(WBC)之间存在相关性(r = - 0.171;P = 0.037),S - Tp与WBC之间存在相关性(r = - 0.170;P = 0.038),以及S - Te与fQRS之间存在相关性(r = 0.158;P = 0.031)。

结论

除QTp、S - Te、S - Tp间期外,我们未发现各组之间在Tp - Te间期等许多TDR指标上存在差异。此外,S - Te与fQRS显示出显著相关性。未来需要建立新的心电图指标来预测室性心律失常和心血管死亡,这将有助于我们区分高危患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e2b/6447328/e6cd3d870cdf/OAMJMS-7-752-g001.jpg

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