新冠病毒肺炎住院患者的心房内阻滞与复极心电图标志物：经典分析与贝叶斯分析
Interatrial Block and Electrocardiographic Markers of Repolarization in Patients Hospitalized with COVID-19: Classical and Bayesian Analysis.
作者信息
Cetin Guvenc Rengin, Guren Ali Kaan, Engur Busra, Celik Selin, Demirtunc Refik
机构信息
Okan University Faculty of Medicine, Department of Cardiology, Istanbul, Turkey.
University of Health Sciences Turkey, Haydarpasa Numune Training and Research Hospital, Clinic of Internal Medicine, Istanbul, Turkey.
出版信息
Medeni Med J. 2023 Dec 26;38(4):236-242. doi: 10.4274/MMJ.galenos.2023.87400.
OBJECTIVE
Coronavirus disease-2019 (COVID-19) is associated with atrial fibrillation (AF) and ventricular arrhythmias. Several electrophysiological abnormalities on surface electrocardiography (ECG) are associated with AF and ventricular arrhythmias, either as markers of abnormal interatrial conduction or abnormal repolarization. The present study sought to understand whether such ECG markers are more common in patients hospitalized with COVID-19 infection during the pandemic.
METHODS
A total of 87 COVID-19 patients formed the study group, whereas 64 patients who were hospitalized for any reason other than COVID-19 infection served as controls. The frequency of partial and advanced interatrial block (IAB), QT and corrected QT (QTc) durations, QT dispersion (QTd), and T peak-to-end duration (Tpe) were measured from ECGs at admission.
RESULTS
Both partial and advanced IAB were more common in patients with COVID-19, although statistical significance was only observed for advanced IAB (11.5% in COVID-19 patients vs. 0.0% in controls, p=0.005). There were no differences between the groups for QTc, QTd or Tpe. On Bayesian analyses, there was strong evidence favoring an association between COVID-19 and advanced IAB (BF10:16), whereas there was no evidence for an association for partial IAB, QTc, QTd, or Tpe (BF<1 for all).
CONCLUSIONS
Patients hospitalized with COVID-19 were more likely to have advanced IAB, which may explain why AF is more frequent in these patients.
目的
2019冠状病毒病（COVID-19）与心房颤动（AF）和室性心律失常有关。体表心电图（ECG）上的几种电生理异常与AF和室性心律失常有关，可作为心房间传导异常或复极异常的标志物。本研究旨在了解在大流行期间，这些ECG标志物在因COVID-19感染住院的患者中是否更常见。
方法
共有87例COVID-19患者组成研究组，64例因COVID-19感染以外的任何原因住院的患者作为对照组。入院时通过心电图测量部分和进展性心房传导阻滞（IAB）、QT和校正QT（QTc）间期、QT离散度（QTd）以及T峰末间期（Tpe）的频率。
结果
部分和进展性IAB在COVID-19患者中更常见，尽管仅进展性IAB具有统计学意义（COVID-19患者中为11.5%，对照组中为0.0%，p = 0.005）。两组之间QTc、QTd或Tpe无差异。在贝叶斯分析中，有强有力的证据支持COVID-19与进展性IAB之间存在关联（BF10:16），而对于部分IAB、QTc、QTd或Tpe则没有关联的证据（所有BF均<1）。
结论
因COVID-19住院的患者更有可能出现进展性IAB，这可能解释了为什么这些患者中AF更常见。
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