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Ann Noninvasive Electrocardiol. 2018 Nov;23(6):e12582. doi: 10.1111/anec.12582. Epub 2018 Jul 4.
2
Tp-e interval and Tp-e/QTc ratio: new choices for risk stratification of arrhythmic events in patients with hypertrophic cardiomyopathy.Tp-e间期与Tp-e/QTc比值:肥厚型心肌病患者心律失常事件危险分层的新选择
Anatol J Cardiol. 2017 Jun;17(6):493. doi: 10.14744/AnatolJCardiol.2017.7865.
3
Tp-e interval and Tp-e/QTc ratio as novel surrogate markers for prediction of ventricular arrhythmic events in hypertrophic cardiomyopathy.Tp-e间期和Tp-e/QTc比值作为预测肥厚型心肌病室性心律失常事件的新型替代标志物。
Anatol J Cardiol. 2017 Jul;18(1):48-53. doi: 10.14744/AnatolJCardiol.2017.7581. Epub 2017 Mar 9.
4
Prognostic Value of LGE-CMR in HCM: A Meta-Analysis.LGE-CMR 在 HCM 中的预后价值:一项荟萃分析。
JACC Cardiovasc Imaging. 2016 Dec;9(12):1392-1402. doi: 10.1016/j.jcmg.2016.02.031. Epub 2016 Jul 20.
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LGE Means Better Selection of HCM Patients for Primary Prevention Implantable Defibrillators.延迟强化成像有助于更好地筛选肥厚型心肌病患者以进行一级预防植入式心脏除颤器治疗。
JACC Cardiovasc Imaging. 2016 Dec;9(12):1403-1406. doi: 10.1016/j.jcmg.2016.01.032. Epub 2016 Jul 20.
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Independent Assessment of the European Society of Cardiology Sudden Death Risk Model for Hypertrophic Cardiomyopathy.欧洲心脏病学会肥厚型心肌病猝死风险模型的独立评估
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Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.成人经超声心动图进行心腔定量的建议:美国超声心动图学会和欧洲心血管影像学会的更新版
Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):233-70. doi: 10.1093/ehjci/jev014.
9
2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC).2014年欧洲心脏病学会(ESC)肥厚型心肌病诊断和治疗指南:欧洲心脏病学会(ESC)肥厚型心肌病诊断和治疗工作组
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10
A novel clinical risk prediction model for sudden cardiac death in hypertrophic cardiomyopathy (HCM risk-SCD).肥厚型心肌病患者心脏性猝死的新型临床风险预测模型(HCM risk-SCD)。
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心脏磁共振检测的心肌纤维化与肥厚型心肌病患者Tp-e间期、5年心源性猝死风险评分之间的关系。

The relationship between myocardial fibrosis detected by cardiac magnetic resonance and Tp-e interval, 5-year sudden cardiac death risk score in hypertrophic cardiomyopathy patients.

作者信息

Riza Demir Ali, Celik Ömer, Sevinç Samet, Uygur Begüm, Kahraman Serkan, Yilmaz Emre, Cemek Mete, Onal Yilmaz, Erturk Mehmet

机构信息

Department of Cardiology, University of Health Science, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Department of Cardiology, Akçakale State Hospital, Urfa, Turkey.

出版信息

Ann Noninvasive Electrocardiol. 2019 Sep;24(5):e12672. doi: 10.1111/anec.12672. Epub 2019 Jun 1.

DOI:10.1111/anec.12672
PMID:31152489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6931578/
Abstract

BACKGROUND

The aim of this study was to investigate the relationship between QT (QTc) interval, Tp-e interval, Tp-e/QTc ratio, 5-year sudden cardiac death (SCD) risk score, and late gadolinium enhancement (LGE) detected by CMR in hypertrophic cardiomyopathy (HCM) patients.

METHOD

A total of 74 consecutive patients who underwent CMR with HCM diagnosis were included in the study. These patients were divided into two groups according to the presence of LGE on CMR. All patients underwent detailed echocardiography and QTc interval, Tp-e interval, and Tp-e/QTc ratios and 5-year SCD risk scores were calculated. These parameters were compared for two groups.

RESULTS

CMR revealed LGE in 32 (43.2%) of 74 HCM patients. In the group with LGE, significantly higher QTc interval (p = 0.002), Tp-e interval (p < 0.001), Tp-e/QTc ratio (p = 0.004), and 5-year SCD risk score were detected. In addition, QTc interval, Tp-e interval, Tp-e/QTc ratio, maximum wall thickness, left ventricular mass index, 5-year SCD risk score, and cardiac fibrosis index were found to be correlated with various degrees in correlation analysis. Also, Tp-e interval is found to be an independent predictor of LGE detected by CMR in HCM patients (p = 0.017, OR [%95 CI] = 1.017 [1.001-1.034]). In addition, the Tp-e interval can detect the LGE with a sensitivity of 64.3% and a specificity of 84.2% at 99.4 ms. (p < 0.001, AUC [95% CI] = 0.790 [0.676-0.905]).

CONCLUSION

The Tp-e interval can be used to optimize SCD risk stratification in HCM patients and determine which patients will benefit from implantable cardioverter-defibrillator (ICD) treatment.

摘要

背景

本研究旨在探讨肥厚型心肌病(HCM)患者的QT(QTc)间期、Tp-e间期、Tp-e/QTc比值、5年心源性猝死(SCD)风险评分与心脏磁共振成像(CMR)检测到的晚期钆增强(LGE)之间的关系。

方法

本研究共纳入74例连续接受CMR检查且诊断为HCM患者。根据CMR上是否存在LGE将这些患者分为两组。所有患者均接受详细的超声心动图检查,并计算QTc间期、Tp-e间期、Tp-e/QTc比值以及5年SCD风险评分。对两组的这些参数进行比较。

结果

CMR显示74例HCM患者中有32例(43.2%)存在LGE。在存在LGE的组中,检测到QTc间期(p = 0.002)、Tp-e间期(p < 0.001)、Tp-e/QTc比值(p = 0.004)以及5年SCD风险评分显著更高。此外,在相关性分析中发现QTc间期、Tp-e间期、Tp-e/QTc比值、最大壁厚、左心室质量指数、5年SCD风险评分以及心脏纤维化指数存在不同程度的相关性。而且,发现Tp-e间期是CMR检测到的HCM患者LGE的独立预测因子(p = 0.017,OR[95%CI]=1.017[1.001 - 1.034])。此外,Tp-e间期在99.4毫秒时检测LGE的灵敏度为64.3%,特异度为84.2%(p < 0.001,AUC[95%CI]=0.790[0.676 - 0.905])。

结论

Tp-e间期可用于优化HCM患者的SCD风险分层,并确定哪些患者将从植入式心脏复律除颤器(ICD)治疗中获益。