Chan Cheng-Han, Hu Yu-Feng, Chen Pei-Fen, Wu I-Chien, Chen Shih-Ann
Department of Medicine, Taipei Veterans General Hospital.
Faculty of Medicine, National Yang-Ming University.
Acta Cardiol Sin. 2022 Mar;38(2):124-133. doi: 10.6515/ACS.202203_38(2).20211101A.
Congenital long QT syndrome (LQTS) causes life-threatening cardiac arrhythmias and is the leading cause of sudden cardiac death in young people. Measurements of QT prolongation during exercise or postural change have been recommended to assist in the diagnosis of LQTS, particularly in those with hidden phenotypes. However, most evidence has come from single-center studies without external validation in an independent cohort. Inter-study heterogeneity leads to significant difficulties in interpreting and applying consistent diagnostic criteria for LQTS. A comprehensive systematic review is critically needed to summarize the evidence and validate the diagnostic performance of QT intervals during exercise or postural change across a variety of studies. In this study, we review cross-sectional and cohort studies evaluating the efficacy and feasibility of exercise tests or postural changes in diagnosing LQTS, and propose possible problems resulting from exercise tests.
先天性长QT综合征（LQTS）可引发危及生命的心律失常，是年轻人心脏性猝死的主要原因。建议在运动或体位改变时测量QT间期延长情况，以辅助LQTS的诊断，尤其是对那些具有隐匿表型的患者。然而，大多数证据来自单中心研究，缺乏在独立队列中的外部验证。研究间的异质性导致在解释和应用一致的LQTS诊断标准时存在重大困难。迫切需要进行全面的系统评价，以总结证据并验证在各种研究中运动或体位改变时QT间期的诊断性能。在本研究中，我们回顾了评估运动试验或体位改变在诊断LQTS中的有效性和可行性的横断面研究和队列研究，并提出了运动试验可能存在的问题。
