QT 间期持续时间的 6 年变化与心力衰竭事件风险 - 社区动脉粥样硬化风险研究的二次分析。
Six-Year Change in QT Interval Duration and Risk of Incident Heart Failure - A Secondary Analysis of the Atherosclerosis Risk in Communities Study.
机构信息
Cardiology Department, First Affiliated Hospital of Sun Yat-Sen University.
NHC Key Laboratory of Assisted Circulation (Sun Yat-Sen University).
出版信息
Circ J. 2021 Apr 23;85(5):640-646. doi: 10.1253/circj.CJ-20-0719. Epub 2020 Dec 2.
BACKGROUND
Few studies have investigated the association between temporal change in QT interval and incident heart failure (HF). The aim of this study is to examine this association in the Atherosclerosis Risk in Communities (ARIC) study.
METHODS AND RESULTS
A secondary analysis was performed for the ARIC study. Overall, 10,274 participants (age 60.0±5.7 years, 45.7% male and 19.5% black) who obtained a 12-lead electrocardiography (ECG) at both Visit 1 (1987-1989) and Visit 3 (1993-1995) in the ARIC study were included. QT interval duration was corrected by using Bazett's formula (QTc). The change in corrected QT interval duration (∆QTc) was calculated by subtracting QTc at Visit 3 from Visit 1. The main outcome measure was incident HF. Multivariable Cox regression models were used to assess the association between ∆QTc and incident HF. During a median follow up of 19.5 years, 1,833 cases (17.8%) of incident HF occurred. ∆QTc was positively associated with incident HF (HR: 1.06, 95% CI 1.03, 1.08, per 10 ms increase, P<0.001; HR 1.22, 95% CI 1.08, 1.36, T3 vs. T1, P=0.002), after adjusting for traditional cardiovascular risk factor, QTc and QRS duration.
CONCLUSIONS
Temporal increases in QTc are independently associated with increased risk of HF.
背景
很少有研究调查 QT 间期的时间变化与心力衰竭（HF）事件之间的关系。本研究旨在 ARIC 研究中检验这种关联。
方法和结果
对 ARIC 研究进行了二次分析。共有 10274 名参与者（年龄 60.0±5.7 岁，45.7%为男性，19.5%为黑人），他们在 ARIC 研究中的第 1 次就诊（1987-1989 年）和第 3 次就诊（1993-1995 年）时都接受了 12 导联心电图（ECG）检查。QT 间期由 Bazett 公式（QTc）校正。通过从第 3 次就诊时的 QTc 中减去第 1 次就诊时的 QTc 来计算校正 QT 间期的变化（∆QTc）。主要结局指标是心力衰竭事件。使用多变量 Cox 回归模型评估 ∆QTc 与心力衰竭事件之间的关系。在中位数为 19.5 年的随访期间，发生了 1833 例（17.8%）心力衰竭事件。∆QTc 与心力衰竭事件呈正相关（HR：1.06，95%CI 1.03，1.08，每增加 10 ms，P<0.001；HR 1.22，95%CI 1.08，1.36，T3 与 T1，P=0.002），在校正传统心血管危险因素、QTc 和 QRS 持续时间后。
结论
QTc 的时间增加与心力衰竭风险的增加独立相关。
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