Moscucci Federica, Sciomer Susanna, Maffei Silvia, Meloni Antonella, Lospinuso Ilaria, Carnovale Myriam, Corrao Andrea, Di Diego Ilaria, Caltabiano Cristina, Mezzadri Martina, Mattioli Anna Vittoria, Gallina Sabina, Rossi Pietro, Magrì Damiano, Piccirillo Gianfranco
Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico n. 155, 00161 Rome, Italy.
Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche, Cardiovascolari, "Sapienza" University of Rome, 00185 Rome, Italy.
J Clin Med. 2023 Jul 16;12(14):4714. doi: 10.3390/jcm12144714.
Aging and chronic heart failure (CHF) are responsible for the temporal inhomogeneity of the electrocardiogram (ECG) repolarization phase. Recently, some short period repolarization-dispersion parameters have been proposed as markers of acute decompensation and of mortality risk in CHF patients. Some important differences in repolarization between sexes are known, but their impact on ECG markers remains unstudied. The aim of this study was to evaluate possible differences between men and women in ECG repolarization markers for the telemonitoring of CHF patients.
5 min ECG recordings were collected to assess the mean and standard deviation (SD) of the following variables: QT end (QTe), QT peak (QTp), and T peak to T end (Te) in 215 decompensated CHF (age range: from 49 to 103 years). Thirty-day mortality and high levels of NT-pro BNP (<75 percentile) were considered markers of decompensated CHF.
A total of 34 patients (16%) died during the 30-day follow-up, without differences between sexes. Women showed a more preserved ejection fraction and higher LDL and total cholesterol levels. Among female patients, implantable cardioverter devices, statins, and antiplatelet agents were less used. Data for Te mean showed increased values among deceased men and women compared to survival, but Te was shown to be the most reliable marker for CHF reacutization in both sexes.
Te could be considered a risk factor for CHF worsening and complications for female and male patients, but different cut offs should be taken into account. (ClinicalTrials.gov number, NCT04127162.).
衰老和慢性心力衰竭（CHF）是心电图（ECG）复极期时间不均一性的原因。最近，一些短程复极离散参数已被提议作为CHF患者急性失代偿和死亡风险的标志物。已知两性在复极方面存在一些重要差异，但它们对ECG标志物的影响尚未得到研究。本研究的目的是评估在CHF患者远程监测中，男女在ECG复极标志物方面可能存在的差异。
收集215例失代偿性CHF患者（年龄范围：49至103岁）5分钟的ECG记录，以评估以下变量的平均值和标准差（SD）：QT终点（QTe）、QT峰值（QTp）和T峰到T终点（Te）。30天死亡率和高水平的NT - pro BNP（<第75百分位数）被视为失代偿性CHF的标志物。
在30天的随访期间，共有34例患者（16%）死亡，男女之间无差异。女性的射血分数保留更好，低密度脂蛋白和总胆固醇水平更高。在女性患者中，植入式心脏复律除颤器、他汀类药物和抗血小板药物的使用较少。Te平均值的数据显示，与存活患者相比，死亡的男性和女性的值均升高，但Te被证明是两性CHF再急性发作最可靠的标志物。
Te可被视为女性和男性患者CHF恶化和并发症的危险因素，但应考虑不同的临界值。（ClinicalTrials.gov编号，NCT04127162.）
