Yilmaz Emre, Aydin Ercan
Op. Dr. Ergun Ozdemir Gorele State Hospital, Department of Cardiology, Giresun, Turkey.
Vakfikebir State Hospital, Department of Cardiology, Trabzon, Turkey.
J Electrocardiol. 2021 Jan-Feb;64:76-79. doi: 10.1016/j.jelectrocard.2020.11.015. Epub 2020 Dec 8.
Low iron storage is a common health problem around the world. Although the association of low iron storage with cardiovascular events and various electrocardiographic parameters has been investigated, its association with fragmented QRS (fQRS), T-T (Tp-e) interval, Tp-e/QT and Tp-e/QTc ratios, which are important criteria for repolarization, has not been studied in adults.
A total of 201 female patients in the 18-50 age group with no history of chronic and cardiac disease or anaemia were included in the study. Patients were divided into 3 groups based on their ferritin levels. Twelve lead EKGs were obtained from each patient, and fQRS, Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were calculated manually.
A total of 201 female patients with an average age of 37 ± 9 were included in the study. Group 1 (ferritin<15 ng/mL) consisted of 79 (39.3%) patients, Group 2 (ferritin 15-30 ng/mL) consisted of 64 patients (31.8%) and Group 3 (ferritin≥30 ng/mL) consisted of 58 (28.9%) patients. Tp-e interval was significantly higher in Group 1 compared to Group 2 and 3 (p < 0.001). A similar relationship was also observed between Tp-e/QT, Tp-e/QTc and fQRS (p < 0.001). A moderate, negative relationship was found in the correlation analysis of Tp-e, Tp-e/QT, Tp-e/QTc and fQRS with ferritin value [r = -0.519 (p = 0.001), r = -0.485 (p = 0.001), r = -0.540 (p = 0.001) and r = -0.345 (p = 0.001), respectively].
As a result of the study, it was found that low iron storage may increase arrhythmogenic susceptibility through increased fragmented QRS presence, increased Tp-e interval, Tp-e/QT and Tp-e/QTc ratios in healthy women of childbearing age.
铁储存量低是全球常见的健康问题。尽管已对铁储存量低与心血管事件及各种心电图参数之间的关联进行了研究，但在成年人中，其与碎裂QRS波（fQRS）、T波峰末间期（Tp-e）、Tp-e/QT及Tp-e/QTc比值（复极化的重要指标）之间的关联尚未得到研究。
本研究纳入了18至50岁、无慢性疾病、心脏病或贫血病史的201名女性患者。根据铁蛋白水平将患者分为3组。从每位患者获取12导联心电图，并手动计算fQRS、Tp-e间期、Tp-e/QT及Tp-e/QTc比值。
本研究共纳入201名平均年龄为37±9岁的女性患者。第1组（铁蛋白<15 ng/mL）有79名（39.3%）患者，第2组（铁蛋白15 - 30 ng/mL）有64名（31.8%）患者，第3组（铁蛋白≥30 ng/mL）有58名（28.9%）患者。第1组的Tp-e间期显著高于第2组和第3组（p<0.001）。在Tp-e/QT、Tp-e/QTc与fQRS之间也观察到类似关系（p<0.001）。在对Tp-e、Tp-e/QT、Tp-e/QTc及fQRS与铁蛋白值的相关性分析中发现了中度负相关[r分别为-0.519（p = 0.001）、-0.485（p = 图001）、-0.540（p = 0.001）和-0.345（p = 0.001）]。
研究结果表明，在育龄健康女性中，铁储存量低可能通过增加碎裂QRS波出现率、增加Tp-e间期、Tp-e/QT及Tp-e/QTc比值来增加致心律失常易感性。
