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孤立性冠状动脉扩张患者心律失常风险的心电图标志物

Electrocardiographic markers of arrhythmogenic risk in patients with isolated coronary artery ectasia.

作者信息

Salari Forouzan, Nough Hossein, Seyedhosseini Seyed Mostafa, Namayandeh Seyedeh Mahdieh

机构信息

Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2025 Aug 13;27:200492. doi: 10.1016/j.ijcrp.2025.200492. eCollection 2025 Dec.

Abstract

BACKGROUND

Coronary artery ectasia (CAE) is an uncommon finding with potential clinical implications, including arrhythmogenic risk. Electrocardiographic parameters such as QT dispersion (QTd) and P wave dispersion (PWD) have been proposed as non-invasive predictors of electrical instability. This study aimed to compare ECG findings, between patients with isolated CAE and those with normal coronary arteries.

METHODS

In this case-control study, 23 patients with isolated CAE (Group 1) and 26 patients with angiographically normal coronary arteries (Group 2) were enrolled. Groups were matched for age, gender, cardiovascular risk factors, and ejection fraction. Patients with conditions or medications affecting conduction were excluded. ECG parameters were compared using Chi-square and unpaired t-tests. Additional subgroup analyses using ANOVA, Spearman correlation, and linear mixed models were performed.

RESULTS

T wave inversion was significantly more common in Group 1 than Group 2 (52.2 % vs. 11.5 %,  = 0.006). QTc was significantly prolonged in Group 1 ( = 0.046). QTd, QTcd, and PWD were all significantly greater in Group 1 ( < 0.05). QTd, QTcd, and PWD were positively correlated with the number of ectatic vessels ( < 0.001). However, PR interval, QRS duration, and QTc did not show significant associations. ECG parameters did not significantly differ based on the specific ectatic vessel. Significant variation in QTd, QTcd, and PWD was observed across different Markis types.

CONCLUSIONS

Patients with isolated CAE exhibit greater QT dispersion and P wave dispersion compared to controls, suggesting a higher arrhythmogenic potential. These parameters also correlate with the extent and classification of ectasia, highlighting their potential utility in risk stratification.

摘要

背景

冠状动脉扩张(CAE)是一种不常见的表现,具有潜在的临床意义,包括致心律失常风险。心电图参数如QT离散度(QTd)和P波离散度(PWD)已被提出作为电不稳定的非侵入性预测指标。本研究旨在比较孤立性CAE患者与冠状动脉正常患者的心电图表现。

方法

在这项病例对照研究中,纳入了23例孤立性CAE患者(第1组)和26例冠状动脉造影正常的患者(第2组)。两组在年龄、性别、心血管危险因素和射血分数方面进行匹配。排除患有影响传导的疾病或正在服用影响传导药物的患者。使用卡方检验和非配对t检验比较心电图参数。还进行了使用方差分析、Spearman相关性分析和线性混合模型的额外亚组分析。

结果

第1组T波倒置明显比第2组更常见(52.2%对11.5%,P = 0.006)。第1组QTc明显延长(P = 0.046)。第1组的QTd、QTcd和PWD均明显更大(P < 0.05)。QTd、QTcd和PWD与扩张血管的数量呈正相关(P < 0.001)。然而,PR间期、QRS时限和QTc未显示出显著相关性。心电图参数根据特定的扩张血管没有显著差异。在不同的Markis类型中观察到QTd、QTcd和PWD有显著变化。

结论

与对照组相比,孤立性CAE患者表现出更大的QT离散度和P波离散度,提示更高的致心律失常潜力。这些参数也与扩张的程度和分类相关,突出了它们在风险分层中的潜在效用。

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