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子痫前期的心脏电活动和结构改变。

Cardiac electrical and structural alterations in preeclampsia.

作者信息

Aksu Ekrem, Cuglan Bilal, Tok Abdullah, Celik Enes, Doganer Adem, Sokmen Abdullah, Sokmen Gulizar

机构信息

Department of Cardiology, Faculty of Medicine, Sutcu Imam University, Kahramanmaras, Turkey.

Department of Cardiology, Faculty of Medicine, Beykent University, Istanbul, Turkey.

出版信息

J Matern Fetal Neonatal Med. 2022 Jan;35(1):1-10. doi: 10.1080/14767058.2021.1895742. Epub 2021 Mar 7.

Abstract

BACKGROUND

Preeclampsia increases the risk of cardiovascular mortality and morbidity both during pregnancy and long term after the labor by causing cardiac changes that may lead to atrial and ventricular arrhythmias.

OBJECTIVE

We aimed to investigate noninvasive predictors of atrial and ventricular arrhythmias and cardiac structural changes in preeclampsia.

METHODS

The study included 34 preeclampsia patients as the study group and 33 healthy pregnant women as the control group. The presence of fragmented QRS morphology, P dispersion, QT dispersion, Tp-e/QTc ratio, inter- and intra-atrial electromechanical delay, left ventricular mass index was evaluated in the groups by 12 lead- ECG and standard and tissue Doppler echocardiography.

RESULTS

Left ventricular mass index and relative wall thickness, and E/Em ratio was significantly higher in preeclampsia. Inter- and intra-atrial electromechanical delay and Tp-e were prolonged, and P dispersion, QT dispersion, and Tp-e/QTc ratio were increased significantly in patients with preeclampsia. In addition, fragmented QRS morphology was seen in 76.5% of patients with preeclampsia while it was present in only 27.3% of the control group ( < .001).

CONCLUSION

Preeclampsia causes significant cardiac structural and electrocardiographic alterations that may increase the risk of atrial and/or ventricular arrhythmias. A more thorough and earlier cardiac assessment and closer follow-up of these patients would be useful to avoid further complications.

摘要

背景

子痫前期会增加孕期及产后长期心血管疾病死亡率和发病率,因为其会引发心脏变化,进而可能导致房性和室性心律失常。

目的

我们旨在研究子痫前期患者房性和室性心律失常及心脏结构变化的无创预测指标。

方法

本研究纳入34例子痫前期患者作为研究组,33例健康孕妇作为对照组。通过12导联心电图以及标准和组织多普勒超声心动图评估两组患者碎裂QRS波形态、P波离散度、QT离散度、Tp-e/QTc比值、心房内及心房间机电延迟、左心室质量指数。

结果

子痫前期患者的左心室质量指数、相对室壁厚度以及E/Em比值显著更高。子痫前期患者的心房间及心房内机电延迟和Tp-e延长,P波离散度、QT离散度以及Tp-e/QTc比值显著增加。此外,76.5%的子痫前期患者出现碎裂QRS波形态,而对照组仅有27.3%出现(<0.001)。

结论

子痫前期会导致显著的心脏结构和心电图改变,这可能会增加房性和/或室性心律失常的风险。对这些患者进行更全面、更早的心脏评估以及更密切的随访,有助于避免进一步的并发症。

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