儿童经导管肺动脉瓣置换术后PR间期和QRS间期的变化
PR and QRS interval changes after transcatheter pulmonary valve replacement in children.
作者信息
Helal Abdelmonem M, Baho Haysam A, Elmahrouk Ahmed F, Mashali Mohamed H
机构信息
Pediatric Cardiology Department, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia.
Department of Pediatrics, Pediatric Cardiology Division, Cairo University, Cairo, Egypt.
出版信息
Egypt Heart J. 2023 Jul 24;75(1):66. doi: 10.1186/s43044-023-00394-x.
BACKGROUND
Changes in PR intervals after transcatheter pulmonary valve replacement (TCPVR) have not been thoroughly evaluated in children. This study evaluated the changes in PR and QRS intervals six months after TCPVR in children with congenital heart disease.
RESULTS
This study included 41 patients who underwent TCPVR from 2010 to 2022. ECG of patients was reviewed before and six months after TCPVR, and the PR and QRS intervals were reported. Right ventricular systolic pressure (RVSP) was retrieved indirectly from echocardiography and compared pre- and 6-months after TPVR. The median age was 13 years (25th-75th percentiles: 11-16), and 61% were males. The preoperative diagnosis was tetralogy of Fallot (n = 29, 71%), transposition of great vessels (n = 4, 10%), common arterial trunk (n = 3, 7%), pulmonary valve stenosis (n = 3, 7%) and pulmonary atresia (n = 2, 5%). The Melody valve was used in 30 patients, and Edwards Sapien was used in 11 patients. RVSP was significantly reduced six months after the procedure (pre-RVSP 40 (30-55) mmHg vs. post-RVSP 25 (20-35) mmHg; P < 0.001). The PR interval was 142 (132-174) msec before TPVR and 146 (132-168) msec post-TCPVR (P = 0.442). Post-TPVR PR was positively related to the pre-PR (β: 0.79 (0.66-0.93), P < 0.001) and inversely related to the right ventricular outflow tract size (- 1.48 (- 2.76 to - 0.21), P = 0.023). The pre-TPVR QRS was 130 (102-146) msec, and the post-TPVR QRS was 136 (106-144) msec (P = 0.668).
CONCLUSIONS
In children undergoing TCPVR, the PR and QRS intervals did not change significantly during a 6-month follow-up.
背景
经导管肺动脉瓣置换术（TCPVR）后PR间期的变化在儿童中尚未得到充分评估。本研究评估了先天性心脏病患儿TCPVR术后6个月PR和QRS间期的变化。
结果
本研究纳入了2010年至2022年期间接受TCPVR的41例患者。回顾了患者在TCPVR术前和术后6个月的心电图，并报告了PR和QRS间期。通过超声心动图间接获取右心室收缩压（RVSP），并在TPVR术前和术后6个月进行比较。中位年龄为13岁（第25-75百分位数：11-16岁），61%为男性。术前诊断为法洛四联症（n = 29，71%）、大动脉转位（n = 4，10%）、共同动脉干（n = 3，7%）、肺动脉瓣狭窄（n = 3，7%）和肺动脉闭锁（n = 2，5%）。30例患者使用了Melody瓣膜，11例患者使用了爱德华兹Sapien瓣膜。术后6个月RVSP显著降低（术前RVSP 40（30-55）mmHg vs.术后RVSP 25（20-35）mmHg；P < 0.001）。TPVR术前PR间期为142（132-174）毫秒，TCPVR术后为146（132-168）毫秒（P = 0.442）。TPVR术后PR与术前PR呈正相关（β：0.79（0.66-0.93），P < 0.001），与右心室流出道大小呈负相关（-1.48（-2.76至-0.21），P = 0.023）。TPVR术前QRS为130（102-146）毫秒，TPVR术后QRS为136（106-144）毫秒（P = 0.668）。
结论
在接受TCPVR的儿童中，PR和QRS间期在6个月的随访期间没有显著变化。
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