Cavallini B, Perri V, Sali M
Ospedale Civile San Giovanni Bianco, Bergamo, Servizio di Cardiologia.
Minerva Cardioangiol. 1996 Jan-Feb;44(1-2):45-8.
QT interval dispersion (QTD) is considered to reflect the inhomogeneity of ventricular repolarization. Increased QTD has been shown to be positively correlated to complex ventricular arrhythmias (CVA) in many clinical conditions. The aim of this study was to assess QTD in arterial hypertension with left ventricular hypertrophy (LVH) and to verify the possible relationship between increased QTD and the presence of CVA in this population. We studied 100 patients with essential arterial hypertension, aged 25-78 years, mean 53. Half of the patients had LVH (group A); LVH was defined as diastolic septal thickness of 1.2 cm or more (by echocardiography). The septum was 1.1 cm or less in the patients without LVH (group B). QTc intervals were measured on the 12-lead surface ECG; QTD was defined as the difference between the longest and the shortest QTc. The presence of Lown class 2 (or more) ventricular arrhythmias on a 24-hour Holter monitoring was considered CVA. In the 100 patients studied, QTD ranged from 10 to 128 ms, mean 43.7 ms. It was longer in group A than in group B; 56.1 ms versus 51.5 ms (mean values). 14 patients in group A had CVA; they had a shorter QTD than patients without CVA: 51.2 ms versus 57.9 ms. In patients with essential arterial hypertension the presence of LVH is positively correlated to increased QTD. Increased QTD however does not seem to be an adjunctive risk factor for CVA in is population.
QT间期离散度(QTD)被认为可反映心室复极的不均一性。在许多临床情况下,QTD增加已被证明与复杂性室性心律失常(CVA)呈正相关。本研究的目的是评估伴有左心室肥厚(LVH)的动脉高血压患者的QTD,并验证该人群中QTD增加与CVA存在之间的可能关系。我们研究了100例年龄在25 - 78岁、平均53岁的原发性动脉高血压患者。其中一半患者有LVH(A组);LVH定义为舒张期室间隔厚度≥1.2 cm(通过超声心动图)。无LVH的患者室间隔厚度≤1.1 cm(B组)。在12导联体表心电图上测量QTc间期;QTD定义为最长与最短QTc之间的差值。24小时动态心电图监测出现Lown 2级(或更高)室性心律失常被视为CVA。在研究的100例患者中,QTD范围为10至128 ms,平均43.7 ms。A组的QTD长于B组;分别为56.1 ms和51.5 ms(平均值)。A组有14例患者发生CVA;他们的QTD比无CVA的患者短:51.2 ms对57.9 ms。在原发性动脉高血压患者中,LVH的存在与QTD增加呈正相关。然而,QTD增加似乎不是该人群中CVA的附加危险因素。