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心电图在法洛四联症修复术后患者常规筛查中的重要性是什么?

What Is the Importance of Electrocardiography in the Routine Screening of Patients with Repaired Tetralogy of Fallot?

作者信息

Lubocka Paulina, Sabiniewicz Robert

机构信息

Department of Paediatric Cardiology and Congenital Heart Disease, Medical University of Gdańsk, 80-952 Gdańsk, Poland.

出版信息

J Clin Med. 2021 Sep 22;10(19):4298. doi: 10.3390/jcm10194298.

Abstract

BACKGROUND

In patients following complete repair of the tetralogy of Fallot, the duration of the QRS complex is associated with the size and mechanical function of the right ventricle, which are contemporarily assessed by cardiac magnetic resonance (CMR).

METHODS

38 patients aged 18.0-54.9 years (median age 24.9 years) who had undergone complete repair of the tetralogy of Fallot were examined using CMR and concomitant 24 h ambulatory electrocardiography monitoring. We used statistical analysis to investigate the correlations between electrocardiographic parameters (heart rate, HR; PQ interval, PQ; QRS duration, QRS; and corrected QT interval, QTc) and CMR results (right ventricular ejection fraction, RVEF; right ventricular end-diastolic volume index, RVEDVI; and right ventricular end-systolic volume index, RVESVI) for patients after early and late repair.

RESULTS

The ECG-based parameters were not correlated with time since repair. There were significant correlations between QRS duration and RVEF (r = -0.61), RVEDVI (r = 0.56), and RVESVI (r = 0.54) for early operated patients but not for late-operated patients. No other substantial correlations were reported.

CONCLUSION

Despite its role in screening for arrhythmias, electrocardiography has a limited role as a predictor of morphology and function of the right ventricle in patients after repair of the tetralogy of Fallot.

摘要

背景

在法洛四联症完全修复后的患者中,QRS波群时限与右心室的大小和机械功能相关,目前通过心脏磁共振成像(CMR)进行评估。

方法

对38例年龄在18.0 - 54.9岁(中位年龄24.9岁)且已接受法洛四联症完全修复的患者进行了CMR检查,并同时进行24小时动态心电图监测。我们采用统计分析来研究早期和晚期修复患者的心电图参数(心率、HR;PQ间期、PQ;QRS时限、QRS;校正QT间期、QTc)与CMR结果(右心室射血分数、RVEF;右心室舒张末期容积指数、RVEDVI;右心室收缩末期容积指数、RVESVI)之间的相关性。

结果

基于心电图的参数与修复后的时间无关。对于早期手术患者,QRS时限与RVEF(r = -0.61)、RVEDVI(r = 0.56)和RVESVI(r = 0.54)之间存在显著相关性,但对于晚期手术患者则无此相关性。未报告其他显著相关性。

结论

尽管心电图在筛查心律失常方面发挥作用,但其作为法洛四联症修复后患者右心室形态和功能预测指标的作用有限。

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