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特发性扩张型心肌病中的QT离散度与心律失常事件

QT dispersion and arrhythmic events in idiopathic dilated cardiomyopathy.

作者信息

Grimm W, Steder U, Menz V, Hoffman J, Maisch B

机构信息

Department of Cardiology, Hospital of the Philipps-University of Marburg, Germany.

出版信息

Am J Cardiol. 1996 Aug 15;78(4):458-61. doi: 10.1016/s0002-9149(96)00337-2.

Abstract

QT dispersion was measured in the 12-lead standard electrocardiogram in 107 patients with idiopathic dilated cardiomyopathy (IDC) and 100 age- and sex- matched controls without structural heart disease. All 107 study patients with IDC were prospectively followed in order to determine possible associations between QT dispersion and arrhythmic events, i.e., sustained ventricular tachycardia, ventricular fibrillation, or sudden death. QT dispersion, rate-corrected QT dispersion, and adjusted QTc dispersion, which takes account of the number of leads measured, were significantly greater in patients with IDC than in controls. During 13 +/- 7 months follow-up, arrhythmic events occurred in 12 of 107 study patients with IDC (11%). QT dispersion was increased in patients with versus without arrhythmic events during follow-up (76 +/- 17 vs 60 +/- 26 ms; p=0.03). QTc dispersion and adjusted QTc dispersion were not significantly different between patients with and without arrhythmic events (80 +/- 21 vs 75 +/- 35 ms, and 27 +/- 6 vs 24 +/- 10 ms, respectively). Thus, although QT dispersion was increased in patients with IDC and arrhythmic events during follow-up, its usefulness for arrhythmia risk prediction was limited by the large overlap of QT dispersion between patients with and without arrhythmic events.

摘要

在107例特发性扩张型心肌病(IDC)患者和100例年龄及性别匹配、无结构性心脏病的对照者中,采用12导联标准心电图测量QT离散度。对所有107例IDC研究患者进行前瞻性随访,以确定QT离散度与心律失常事件(即持续性室性心动过速、心室颤动或猝死)之间可能存在的关联。IDC患者的QT离散度、心率校正QT离散度以及考虑测量导联数的校正QTc离散度均显著高于对照组。在13±7个月的随访期间,107例IDC研究患者中有12例(11%)发生了心律失常事件。随访期间发生心律失常事件的患者与未发生心律失常事件的患者相比,QT离散度增加(76±17 vs 60±26 ms;p=0.03)。发生和未发生心律失常事件的患者之间,QTc离散度和校正QTc离散度无显著差异(分别为80±21 vs 75±35 ms以及27±6 vs 24±10 ms)。因此,尽管随访期间IDC患者发生心律失常事件时QT离散度增加,但其对心律失常风险预测的作用因发生和未发生心律失常事件患者之间QT离散度的大量重叠而受到限制。

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