儿童和青少年短QT综合征的新型心电图标准。

Novel electrocardiographic criteria for short QT syndrome in children and adolescents.

作者信息

Suzuki Hiroshi, Horie Minoru, Ozawa Junichi, Sumitomo Naokata, Ohno Seiko, Hoshino Kenji, Ehara Eiji, Takahashi Kazuhiro, Maeda Yoshichika, Yoshinaga Masao, Tateno Shigeru, Takagi Junichi, Doi Shozaburo, Hoshina Satoshi, Sato Isamu, Ishikawa Taisuke, Makita Naomasa, Chinushi Masaomi, Akazawa Kohei, Nagashima Masami

机构信息

Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Niigata 951-8520, Japan.

Department of Cardiovascular Medicine, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan.

出版信息

Europace. 2021 Dec 7;23(12):2029-2038. doi: 10.1093/europace/euab097.

DOI:10.1093/europace/euab097

PMID:34179980

Abstract

AIMS

Although shortening of the corrected QT interval (QTc) is a key finding in the diagnosis of short QT syndrome (SQTS), there may be overlap of the QTc between SQTS patients and normal subjects in childhood and adolescence. We aimed to investigate electrocardiographic findings for differentiation of SQTS patients.

METHODS AND RESULTS

The SQTS group comprised 34 SQTS patients <20 years old, including 9 from our institutions and 25 from previous reports. The control group comprised 61 apparently healthy subjects with an QTc of <360 ms who were selected from 13 314 participants in a school-based screening programme. We compared electrocardiographic findings, including QT and Jpoint-Tpeak intervals (QT and J-Tpeak, respectively), those corrected by using the Bazett's and Fridericia's formulae (cB and cF, respectively) and early repolarization (ER) between the groups. QT, QTc by using Bazett's formula (QTcB), QTc by using Fridericia's formula (QTcF), J-Tpeak, J-Tpeak cB, and J-Tpeak cF were significantly shorter in the SQTS group than in the control group. On receiver operating characteristic curve analysis, the area under the curve (AUC) was largest for QTcB (0.888) among QT, QTcB, and QTcF, with a cut-off value of 316 ms (sensitivity: 79.4% and specificity: 96.7%). The AUC was largest for J-Tpeak cB (0.848) among J-Tpeak, J-Tpeak cB, and J-Tpeak cF, with a cut-off value of 181 ms (sensitivity: 80.8% and specificity: 91.8%). Early repolarization was found more frequently in the SQTS group than in the control group (67% vs. 23%, P = 0.001).

CONCLUSION

A QTcB <316 ms, J-Tpeak cB < 181 ms, and the presence of ER may indicate SQTS patients in childhood and adolescence.

摘要

目的

虽然校正QT间期（QTc）缩短是诊断短QT综合征（SQTS）的关键发现，但儿童和青少年SQTS患者与正常受试者的QTc可能存在重叠。我们旨在研究用于鉴别SQTS患者的心电图表现。

方法与结果

SQTS组包括34例年龄<20岁的SQTS患者，其中9例来自我们的机构，25例来自既往报告。对照组包括61例明显健康的受试者，其QTc<360 ms，这些受试者是从一项基于学校的筛查项目的13314名参与者中挑选出来的。我们比较了两组间的心电图表现，包括QT间期和J点至T波峰间期（分别为QT和J-Tpeak），以及使用Bazett公式和Fridericia公式校正后的QT间期（分别为cB和cF）和早期复极（ER）。SQTS组的QT、使用Bazett公式校正的QTc（QTcB）、使用Fridericia公式校正的QTc（QTcF）、J-Tpeak、J-Tpeak cB和J-Tpeak cF均显著短于对照组。在受试者工作特征曲线分析中，QT、QTcB和QTcF中，QTcB的曲线下面积（AUC）最大（0.888），截断值为316 ms（敏感性：79.4%，特异性：96.7%）。J-Tpeak、J-Tpeak cB和J-Tpeak cF中，J-Tpeak cB的AUC最大（0.848），截断值为181 ms（敏感性：80.8%，特异性：91.8%）。SQTS组早期复极的发生率高于对照组（67%对23%，P = 0.001）。