Department of Cardiology, Clinics Hospital, Universidad Nacional de Asunción, Saint Lorenzo.
Department of Health Sciences Research, Sanatorio Metropolitano Fernando de la Mora. Central Department, Paraguay.
Arch Cardiol Mex. 2023;93(1):69-76. doi: 10.24875/ACM.21000396.
The Tpeak-Tend interval of the T wave has emerged as a new electrocardiographic marker of increased transmural dispersion of ventricular repolarization. We aimed to determine the presence of cardiac conduction system disorders in patients with systemic arterial hypertension (SAH) who have altered Tpeak-Tend interval of the T wave.
The 67 patients with SAH were divided into two groups. Those with prolonged (≥ 77 ms) Tpeak-Tend intervals, 21 (31%) patients were in the study group. Those with normal (< 77 ms) Tpeak-Tend intervals, 46 (69%) patients were in the control group. Alteration of ventricular repolarization manifested as a prolongation of the Tpeak-Tend interval was detected by computerized electrocardiographic analysis tools.
The median value of QRS complex duration was significantly wider in the study group as compared to the control group (110 ± 12 ms vs. 94 ± 8 ms p < 0.001). There was a significantly greater incidence of left anterior hemiblock in the study group (14% vs. 0% p < 0.04). The median value of the QTc interval was significantly greater in the study group (440 ± 26 vs. 422 ± 15 p < 0.01). There was a significantly greater incidence of patients with prolonged QTc interval in the study group (33% vs. 11% p < 0.02). The median value of the Tpeak-Tend interval was significantly greater in the study group (84 ± 5 ms vs. 65 ± 4 ms p < 0.001), as well as, the Tpeak-Tend/QTc ratio in the study group (0.19 ± 0.1 vs. 0.16 ± 0.1 p < 0.001).
There is a significantly greater ventricular repolarization disorders and abnormalities of the cardiac conduction system in SAH patients who possess altered Tpeak-Tend interval of the T wave.
T 波的 Tpeak-Tend 间期已成为心室复极跨壁离散度增加的新心电图标志物。我们旨在确定 T 波 Tpeak-Tend 间期改变的全身性动脉高血压(SAH)患者是否存在心脏传导系统障碍。
将 67 例 SAH 患者分为两组。Tpeak-Tend 间期延长(≥77ms)的 21 例(31%)患者为观察组,Tpeak-Tend 间期正常(<77ms)的 46 例(69%)患者为对照组。通过计算机心电图分析工具检测心室复极改变表现为 Tpeak-Tend 间期延长。
观察组 QRS 波群持续时间的中位数明显宽于对照组(110±12ms 比 94±8ms,p<0.001)。观察组左前分支阻滞的发生率明显较高(14%比 0%,p<0.04)。观察组 QTc 间期的中位数明显较大(440±26 比 422±15,p<0.01)。观察组 QTc 间期延长的患者比例明显较高(33%比 11%,p<0.02)。观察组 Tpeak-Tend 间期的中位数明显较大(84±5ms 比 65±4ms,p<0.001),观察组 Tpeak-Tend/QTc 比值也明显较大(0.19±0.1 比 0.16±0.1,p<0.001)。
T 波 Tpeak-Tend 间期改变的 SAH 患者存在明显更大的心室复极障碍和心脏传导系统异常。