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缺血性心脏病患者QRS波群碎裂与QT间期延长的相关性

Association of QRS Complex Fragmentation with QT Interval Prolongation in Patients with Ischemic Heart Disease.

作者信息

Aquino N J, Centurión O A, Torales J M, Miño L M, Scavenius K E, Alderete J F, Candia J C, García L B, Cáceres C, Martínez J E, Lovera O A

机构信息

Cardiology Department, Clinic Hospital, Faculty of Medical Sciences, Asunción National University (UNA), San Lorenzo, Paraguay.

Departament of Health Sciences Investigation, Sanatorio Metropolitano, Fernando de la Mora, Paraguay.

出版信息

Curr Health Sci J. 2019 Oct-Dec;45(4):398-404. doi: 10.12865/CHSJ.45.04.08. Epub 2019 Dec 30.

Abstract

BACKGROUND

The fragmented QRS complex (FQRS) was found to be associated to malignant ventricular arrhythmias and sudden death in patients with hypertrophic cardiomyopathy and other entities. There is scant data available correlating the presence of FQRS with QT interval prolongation in patients with ischemic heart disease (IHD).

METHODS

A descriptive, retrospective, cross-sectional study was performed in 123 patients with IHD to analyze and correlate the presence of FQRS with QT interval prolongation in the conventional 12-leads electrocardiogram in patients with documented chronic IHD.

RESULTS

There were 62% male patients. The mean age was 63.8±12.6 years. Thirty six (44%) patients had fragmented QRS (64% men and 36% women). The duration of QT and QTc, the mean values were 413±59ms, and 463±67ms, respectively. Of the 36 patients with FQRS, 23 patients have prolongation of the QTc interval, and 13 patients did not present it. Of the 45 patients without FQRS, 21 of them have prolongation of the QTc interval, and 24 patients did not have it. These data resulted in a sensitivity of 52% with a moderate SnNout, a specificity of 65% with moderate SpPin, a positive predictive accuracy of 64%, a negative predictive accuracy of 53%. These data resulted in a prevalence of 54%.

CONCLUSION

the presence of FQRS in the ECG has a moderate sensitivity and specificity, as well as, moderate negative and positive predictive value of the existence of QT interval prolongation in patients with ischemic heart disease.

摘要

背景

在肥厚型心肌病和其他疾病患者中,发现碎裂QRS波群(FQRS)与恶性室性心律失常和猝死相关。关于缺血性心脏病(IHD)患者中FQRS的存在与QT间期延长之间的相关性,现有数据很少。

方法

对123例IHD患者进行了一项描述性、回顾性横断面研究,以分析记录有慢性IHD的患者常规12导联心电图中FQRS的存在与QT间期延长之间的相关性。

结果

男性患者占62%。平均年龄为63.8±12.6岁。36例(44%)患者有碎裂QRS波群(男性64%,女性36%)。QT和QTc的持续时间,平均值分别为413±59毫秒和463±67毫秒。在36例有FQRS的患者中,23例QTc间期延长,13例未出现。在45例无FQRS的患者中,21例QTc间期延长,24例未延长。这些数据得出的敏感性为52%,具有中等的SnNout,特异性为65%,具有中等的SpPin,阳性预测准确率为64%,阴性预测准确率为53%。这些数据得出的患病率为54%。

结论

心电图中FQRS的存在对缺血性心脏病患者QT间期延长的存在具有中等的敏感性和特异性,以及中等的阴性和阳性预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85cb/7014980/6a8211c7989b/CHSJ-45-4-398-fig1.jpg

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