Gazı State Hospital, Emergency Clinic Samsun, Turkey.
Department of Cardiology, Harran University Faculty of Medicine, Sanliurfa, Turkey.
Am J Emerg Med. 2021 Oct;48:110-113. doi: 10.1016/j.ajem.2021.04.027. Epub 2021 Apr 14.
Conversion disorder is defined as a disorder with one or more neurological symptoms that accompany psychological conflict, suggesting a physical disorder. It has been shown that patients with conversion disorder have an imbalance in the autonomic nervous system. There are only a limited number of studies that have examined how conversion disorder is related with surface ECG parameters. The present study aimed to investigate the effects of conversion disorder on the surface ECG parameters of patients with conversion disorder admitted to the emergency department.
This cross-sectional case-control study included 98 patients who were admitted to the emergency department and diagnosed with conversion disorder and 56 healthy volunteers. All patients underwent 12-derivation ECG. PR interval, P wave dispersion, duration of QRS complex, QT interval, QTc interval, frontal QRS-T angle values were calculated for all individuals.
When compared with the control group, the conversion disorder group revealed a significant difference in terms of PWD [60 (40-80) vs. 40 (40-60) P = 0.01], QT [385 (364-410) vs. 378 (354-394), P = 0.048], QTc [420 (405-430) vs. 406 (397-429), P = 0.039], and frontal QRS-T angle [25 (15-33) vs. 20 (8-35), P = 0.018]. In the multivariate linear regression analysis, conversion disorder was found to be an independent predictor for both PWD (β = 0.196, P = 0.014) and frontal QRS-T angle (β = 0.258, P = 0.011).
This study is the first to show that conversion disorder significantly increases QT, QTc, P wave dispersion, and frontal QRS-T angle.
转换障碍定义为一种具有一种或多种伴随心理冲突的神经系统症状的障碍，提示存在身体障碍。已经表明，转换障碍患者的自主神经系统失衡。只有少数研究检查了转换障碍与体表心电图参数之间的关系。本研究旨在调查转换障碍对急诊科转换障碍患者体表心电图参数的影响。
这项横断面病例对照研究纳入了 98 名因转换障碍而被收入急诊科的患者和 56 名健康志愿者。所有患者均接受 12 导联心电图检查。计算所有个体的 PR 间期、P 波离散度、QRS 波群持续时间、QT 间期、QTc 间期、额面 QRS-T 角值。
与对照组相比，转换障碍组的 PWD [60（40-80）比 40（40-60），P = 0.01]、QT [385（364-410）比 378（354-394），P = 0.048]、QTc [420（405-430）比 406（397-429），P = 0.039]和额面 QRS-T 角 [25（15-33）比 20（8-35），P = 0.018]差异有统计学意义。多元线性回归分析显示，转换障碍是 PWD（β = 0.196，P = 0.014）和额面 QRS-T 角（β = 0.258，P = 0.011）的独立预测因子。
本研究首次表明，转换障碍显著增加 QT、QTc、P 波离散度和额面 QRS-T 角。
