Calò L, Levato M, Sciarra L, Nazzaro M S, Benvissuto F, Borzi M, De Nardo D, Cannata D
Dipartimento di Medicina Interna, Università degli Studi Tor Vergata, Roma.
Cardiologia. 1996 Nov;41(11):1073-7.
Patients with left bundle-branch block (LBBB) often present electrocardiographic abnormalities and, therefore, are excluded from studies concerning electrocardiographic evaluation of ventricular repolarization. The aim of the study was to assess whether LBBB could influence dispersion of ventricular repolarization. Surface electrocardiograms of 16 patients (9 males and 7 females, mean age 58 +/- 14 years) with episodes of intermittent LBBB were analyzed. Six patients were affected by coronary artery disease, 6 by hypertensive cardiomyopathy and 4 by dilated cardiomyopathy. Maximal QT and JT corrected intervals, QT and JT dispersion, and QT and JT dispersion corrected for heart rate, were obtained before and after LBBB. We observed a significant prolongation of maximal QT (412 +/- 29 vs 433 +/- 25 ms; p < 0.05), and of maximal corrected QT (457 +/- 37 vs 497 +/- 56 ms; p < 0.05) after LBBB. Maximal JT interval, also corrected for heart rate, did not show any significant modification after LBBB. Moreover, we did not observe any significant difference in electrocardiographic parameters of dispersion of repolarization. Our results seem to indicate that LBBB did not alter significantly dispersion of ventricular repolarization. QT dispersion is considered an important marker of risk for incidence of ventricular arrhythmias. If our results will be confirmed in larger groups of patients, analysis of QT dispersion could be extended even to patients with LBBB.
左束支传导阻滞(LBBB)患者常出现心电图异常,因此被排除在有关心室复极心电图评估的研究之外。本研究的目的是评估LBBB是否会影响心室复极离散度。分析了16例间歇性LBBB发作患者(9例男性,7例女性,平均年龄58±14岁)的体表心电图。6例患者患有冠状动脉疾病,6例患有高血压性心肌病,4例患有扩张型心肌病。在LBBB发作前后分别获取最大QT间期和JT间期校正值、QT离散度和JT离散度,以及校正心率后的QT离散度和JT离散度。我们观察到LBBB发作后最大QT间期显著延长(412±29 vs 433±25 ms;p<0.05),最大校正QT间期也显著延长(457±37 vs 497±56 ms;p<0.05)。校正心率后的最大JT间期在LBBB发作后未显示出任何显著变化。此外,我们未观察到复极离散度的心电图参数有任何显著差异。我们的结果似乎表明,LBBB并未显著改变心室复极离散度。QT离散度被认为是室性心律失常发生风险的重要标志物。如果我们的结果能在更大规模的患者群体中得到证实,QT离散度分析甚至可以扩展到LBBB患者。