Achmad Chaerul, Iqbal Mohammad, Karwiky Giky, Prameswari Hawani Sasmaya, Febrianora Mega
Cardiology and Vascular Medicine Department, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia.
Hasna Medika Cardiac Hospital, Cirebon, Indonesia.
Cardiol Res. 2020 Jun;11(3):185-191. doi: 10.14740/cr1053. Epub 2020 May 3.
Many studies have shown that T-peak to T-end (TPTE) interval was associated with sudden cardiac events. Peripartum cardiomyopathy (PPCM) causes reversible left ventricle systolic dysfunction which may deteriorate into sudden cardiac death. This study aimed to evaluate beta-blocker as an antiarrhythmic agent to improve TPTE interval as a prognostic value of sudden cardiac death.
A cohort experimental prospective study was performed. The PPCM was diagnosed from the emergency ward. A total of 54 cases were identified from 2014 to 2016. Thirty-four patients were followed up for further analysis. Electrocardiograms were conducted in all the patients, and TPTE interval was measured. After a follow-up of 6 months of beta-blocker treatment, the echocardiography and TPTE interval were measured again to obtain the repolarization heterogeneity.
The mean age of subjects was 32 ± 6.4 years. The mean left ventricular ejection fraction (LVEF) was 32.24±6.3%. The mean TPTE interval was 123.7 ± 28.2 ms. After 6 months of beta-blocker administration, the mean LVEF was 58.26±4.4% and the mean TPTE was 98.7 ± 39.5 ms. The paired -test showed a significant difference between TPTE interval pre- and post-administration of beta-blocker (P value < 0.001).
There is an improvement of TPTE in PPCM patients after 6 months of beta-blocker administration. Administration of beta-blocker in PPCM patients is expected to prevent sudden cardiac death in PPCM populations.
许多研究表明，T波峰至T波终末（TPTE）间期与心脏性猝死事件相关。围产期心肌病（PPCM）可导致可逆性左心室收缩功能障碍，进而可能恶化为心脏性猝死。本研究旨在评估β受体阻滞剂作为抗心律失常药物改善TPTE间期对心脏性猝死的预后价值。
进行一项队列实验性前瞻性研究。从急诊科诊断出PPCM。2014年至2016年共确定了54例病例。对34例患者进行随访以作进一步分析。对所有患者进行心电图检查，并测量TPTE间期。在进行6个月的β受体阻滞剂治疗随访后，再次测量超声心动图和TPTE间期以获得复极异质性。
受试者的平均年龄为32±6.4岁。平均左心室射血分数（LVEF）为32.24±6.3%。平均TPTE间期为123.7±28.2毫秒。给予β受体阻滞剂6个月后，平均LVEF为58.26±4.4%，平均TPTE为98.7±39.5毫秒。配对t检验显示β受体阻滞剂给药前后TPTE间期存在显著差异（P值<0.001）。
给予β受体阻滞剂6个月后，PPCM患者的TPTE有所改善。预计在PPCM患者中给予β受体阻滞剂可预防PPCM人群发生心脏性猝死。
