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高血压患者QTc离散度增加的患病率及其与临床危险因素的相关性:一项基于医院的病例对照研究。

Prevalence of Increased QTc Dispersion Among Hypertensive Patients and Its Correlation to Clinical Risk Factors: A Hospital-Based Case-Control Study.

作者信息

Minkah Md Fwacp Daniel Ohemeng, Owusu Isaac K, Kokuro Collins, Norman Betty R, Arthur Joshua A, Ogyefo Isaac N, Kweki Anthony G

机构信息

Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, GHA.

Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, GHA.

出版信息

Cureus. 2024 Mar 18;16(3):e56423. doi: 10.7759/cureus.56423. eCollection 2024 Mar.

Abstract

Background In Ghana and other sub-Saharan African countries, hypertension (HTN) prevalence is rapidly increasing. Hypertensive left ventricular hypertrophy (LVH) is associated with excess fibrous tissue deposition throughout the myocardium. This could lead to ventricular arrhythmias and sudden cardiac death. Increased corrected QT dispersion (QTcd) can cause ventricular repolarization and be used to identify patients at risk of ventricular tachyarrhythmia. The measurement of increased QTcd among hypertensive patients is a simple screening tool to stratify patients at cardiovascular risk. Methods A case-control hospital-based study was conducted on 200 consecutive hypertensive patients. Age- and sex-matched control groups of 200 normotensive individuals who gave informed consent were also recruited. The baseline clinical and demographic characteristics of participants were acquired using structured questionnaires. A physical examination and a resting 12-lead ECG were performed. Increased QTcd and LVH were determined. Results The mean age of hypertensive patients was 50.99±6.73 and 48.19±7.17 for the controls (p-value 0.63). The study population was predominantly female (1:2.4 male:female ratio). Higher mean values for QTcd and LVH (Sokolow-Lyon) were observed among hypertensive patients compared to controls. The prevalence of increased QTcd was 45.0% among hypertensive patients compared to 16.5% in controls (χ =38.14, p-value <0.0000001, odds ratio = 4.14). Conclusion Increased QTcd is prevalent among hypertensive Ghanaians. Its measurement can be an effective non-invasive screening tool to risk-stratify hypertensive patients.

摘要

背景 在加纳和其他撒哈拉以南非洲国家,高血压(HTN)患病率正在迅速上升。高血压性左心室肥厚(LVH)与整个心肌中过多的纤维组织沉积有关。这可能导致室性心律失常和心源性猝死。校正QT离散度(QTcd)增加可导致心室复极,并用于识别有室性快速心律失常风险的患者。测量高血压患者QTcd增加是一种简单的筛查工具,可对心血管风险患者进行分层。方法 对200例连续的高血压患者进行了一项基于医院的病例对照研究。还招募了200名年龄和性别匹配、签署知情同意书的正常血压个体作为对照组。使用结构化问卷获取参与者的基线临床和人口统计学特征。进行体格检查和静息12导联心电图检查。测定QTcd增加和LVH情况。结果 高血压患者的平均年龄为50.99±6.73岁,对照组为48.19±7.17岁(p值为0.63)。研究人群以女性为主(男女比例为1:2.4)。与对照组相比,高血压患者的QTcd和LVH(索科洛夫-里昂标准)平均值更高。高血压患者中QTcd增加的患病率为45.0%,而对照组为16.5%(χ²=38.14,p值<0.0000001,比值比=4.14)。结论 QTcd增加在加纳高血压患者中普遍存在。其测量可以成为对高血压患者进行风险分层的有效非侵入性筛查工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88be/10948943/45fe84e94171/cureus-0016-00000056423-i01.jpg

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