Section of Pediatric Cardiology, Department of Pediatrics, Comer Children's Hospital and The University of Chicago Pritzker School of Medicine, Chicago, IL, USA; Section of Pediatric Cardiology, Department of Pediatrics, West Virginia University Children's Hospital and West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Department of Pediatrics, Comer Children's Hospital and The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
J Electrocardiol. 2021 Mar-Apr;65:91-95. doi: 10.1016/j.jelectrocard.2021.01.015. Epub 2021 Feb 2.
Electrocardiographic abnormalities such as cardiac axis deviation, conduction abnormalities and ST-segment, and T &P wave abnormalities have been reported in patients with pectus excavatum. The precise determinants of these electrocardiographic abnormalities have however not been systematically evaluated. We therefore carried out this exploratory study to assess the electrocardiographic abnormalities and their determinants in children and young adults with pectus excavatum.
Patients aged between 6 and 22 years with unrepaired pectus excavatum were eligible for enrollment in this preliminary hypothesis generating study, if they were seen at University of Chicago Medical Center between Jan 1, 2017 to Nov 30, 2020, and underwent an electrocardiogram during comprehensive evaluation for pectus excavatum. Pertinent data was collected from the medical charts. Unadjusted and adjusted logistic regression models were used to determine the effect of variables including age, BMI, inspiratory Haller's index, gender, right ventricular geometric distortion and FEV1/FVC (% predicted) on odds of electrocardiographic abnormalities (primary outcome variable). P-values of <0.05 were considered significant.
The study group (16.6 ± 2.9 years, 80% symptomatic) consisted of 28 patients [Caucasian, male (n = 24, 86% each)]. A high proportion (86%) of these patients had geometric distortion of the right ventricle on noninvasive imaging and these patients had a higher Haller's index (4.4 ± 0.95 vs 3.3 ± 0.2, p = 0.03). Approximately 60% of the patients had an abnormal electrocardiogram. Unadjusted and adjusted logistic regression models were utilized to study the determinants of these electrocardiographic abnormalities. Haller's index, BMI, age, gender, geometric distortion of the right ventricle and lung function parameters [FEV1/FEV (% predicted)] were not associated with increased odds of electrocardiographic abnormalities.
Electrocardiographic abnormalities, particularly deviation of cardiac axis, are common in patients with pectus excavatum. In this exploratory hypothesis generating study, Haller's index and geometric distortion of the right ventricle were not associated with these abnormalities. However, systematic multicentric efforts are needed to better define electrocardiographic abnormalities in patients with pectus excavatum and elucidate their precise determinants.
患有漏斗胸的患者会出现心电图异常，如心脏轴偏移、传导异常以及 ST 段和 T&P 波异常。然而，这些心电图异常的确切决定因素尚未得到系统评估。因此，我们进行了这项探索性研究，以评估患有漏斗胸的儿童和青少年的心电图异常及其决定因素。
本初步假设生成研究纳入了年龄在 6 至 22 岁之间、患有未修复的漏斗胸且于 2017 年 1 月 1 日至 2020 年 11 月 30 日期间在芝加哥大学医学中心就诊并在全面评估漏斗胸时接受心电图检查的患者。从病历中收集相关数据。使用未经调整和调整后的逻辑回归模型来确定变量（包括年龄、BMI、吸气 Haller 指数、性别、右心室几何变形和 FEV1/FVC（%预测））对心电图异常（主要结局变量）的影响。p 值<0.05 被认为具有统计学意义。
研究组（16.6±2.9 岁，80%有症状）由 28 名患者组成[白种人，男性（n=24，各占 86%）]。这些患者中有很大一部分（86%）在非侵入性影像学检查中存在右心室的几何变形，这些患者的 Haller 指数更高（4.4±0.95 与 3.3±0.2，p=0.03）。大约 60%的患者心电图异常。使用未经调整和调整后的逻辑回归模型来研究这些心电图异常的决定因素。Haller 指数、BMI、年龄、性别、右心室几何变形和肺功能参数（FEV1/FEV（%预测））与心电图异常的发生几率增加无关。
心电图异常，特别是心脏轴偏移，在漏斗胸患者中很常见。在这项探索性假设生成研究中，Haller 指数和右心室几何变形与这些异常无关。然而，需要系统的多中心努力来更好地定义漏斗胸患者的心电图异常，并阐明其确切决定因素。
