Hohnloser S H, van de Loo A, Arendts W, Zabel M, Just H
Medizinische Universitätsklinik III, Freiburg im Breisgau.
Z Kardiol. 1993 Nov;82(11):678-82.
QT-dispersion defined as the difference between QTmax and QTmin in the 12-lead surface ECG was determined in 33 patients with acute myocardial infarction treated by intravenous thrombolysis. In 11 patients, ventricular fibrillation ensured during the first 24 h after hospital admission. These patients were then compared with 22 matching infarction patients without malignant ventricular rhythm disturbances. QT-dispersion as evaluated in the first ECG taken after hospital admission was significantly higher in patients with (88 +/- 16 ms) compared to QT-dispersion in patients without ventricular fibrillation (66 +/- 19 ms; p < 0.001). When QT-dispersion was again assessed in ECG tracings recorded prior to hospital discharge, it was markedly reduced, with no significant difference between either patient group (53 +/- 16 ms versus 54 +/- 18 ms). These results indicate that QT-dispersion in the surface ECG represents a marker of inhomogeneous repolarization in patients with acute myocardial infarction prone to ventricular fibrillation. This may allow early identification of high-risk patients soon after hospital admission.
在33例接受静脉溶栓治疗的急性心肌梗死患者中，测定了12导联体表心电图中QT离散度，即QTmax与QTmin之间的差值。11例患者在入院后24小时内发生心室颤动。然后将这些患者与22例匹配的无恶性室性心律失常的梗死患者进行比较。入院后首次心电图评估的QT离散度，发生心室颤动的患者（88±16毫秒）明显高于无心室颤动的患者（66±19毫秒；p<0.001）。在出院前记录的心电图描记中再次评估QT离散度时，其明显降低，两组患者之间无显著差异（53±16毫秒对54±18毫秒）。这些结果表明，体表心电图中的QT离散度代表了易发生心室颤动的急性心肌梗死患者复极不均一性的一个指标。这可能有助于在入院后不久早期识别高危患者。
