法洛四联症修复术后患者右心室扩张的心电图指标
Electrocardiogram indicators of right ventricular dilation in repaired tetralogy of Fallot patients.
作者信息
Hiya Uchina, Kabutoya Tomoyuki, Fujimura Kenta, Kubota Kana, Imai Yasushi, Yokomizo Akiko, Seki Mitsuru, Kario Kazuomi
机构信息
Faculty of Medicine, Jichi Medical University, Shimotsuke, Japan.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.
出版信息
Expert Rev Cardiovasc Ther. 2025 Jul;23(7):367-371. doi: 10.1080/14779072.2025.2524566. Epub 2025 Jun 27.
BACKGROUND
Patients with surgically repaired tetralogy of Fallot (rTOF) often develop chronic pulmonary regurgitation (PR), necessitating pulmonary valve replacement (PVR). While cardiac MRI is crucial for PVR timing, its availability is limited. This study evaluates electrocardiographic (ECG) findings - specifically the R-wave amplitude in lead V1 (V1R) and the sum of the R-wave amplitude in lead V1 and the deepest S-wave amplitude in lead V5 or V6 (V1R + V5S or V6S) - as predictors of cardiac MRI findings.
PATIENTS AND METHODS
We retrospectively analyzed 35 rTOF patients (mean age 34 ± 9 years; 60% male) who underwent cardiac MRI from 2019 to 2022, assessing correlations between ECG parameters (V1R, V1R + V5S or V6S, and QRS duration) and MRI findings (RVESVI and RVEDVI).
RESULTS
V1R showed significant correlation with RVESVI ( = 0.486, = 0.003) and was notably higher in patients with RVESVI ≥ 80 mL/m. A V1R cutoff of 20 mm identified RVESVI ≥ 80 mL/m with 67% sensitivity and 77% specificity.
CONCLUSIONS
V1R on ECG may help predict the need for cardiac MRI, aiding in the timely PVR planning for rTOF patients.
背景
接受法洛四联症手术修复（rTOF）的患者常发生慢性肺动脉反流（PR），需要进行肺动脉瓣置换术（PVR）。虽然心脏磁共振成像对于确定PVR时机至关重要，但其可用性有限。本研究评估心电图（ECG）表现——特别是V1导联的R波振幅（V1R）以及V1导联的R波振幅与V5或V6导联最深S波振幅之和（V1R + V5S或V6S）——作为心脏磁共振成像表现的预测指标。
患者和方法
我们回顾性分析了2019年至2022年期间接受心脏磁共振成像的35例rTOF患者（平均年龄34±9岁；60%为男性），评估心电图参数（V1R、V1R + V5S或V6S以及QRS时限）与磁共振成像表现（右心室舒张末期容积指数[RVESVI]和右心室收缩末期容积指数[RVEDVI]）之间的相关性。
结果
V1R与RVESVI显著相关（r = 0.486，P = 0.003），且在RVESVI≥80 mL/m²的患者中明显更高。V1R截断值为20 mm时，识别RVESVI≥80 mL/m²的敏感性为67%，特异性为77%。
结论
心电图上的V1R可能有助于预测心脏磁共振成像的需求，有助于为rTOF患者及时制定PVR计划。
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