Catuli D, Maison-Blanche P, Fayn J, Rubel P, Larroque P, Vacheron A, Coumel P
Hôpital Necker, Paris.
Arch Mal Coeur Vaiss. 1997 Jul;90(7):927-34.
Adaptation of ventricular repolarization duration to heart rate provides additional information to the static duration of QT interval.
QT/RR relation and his slope were determined using 24-hour ECG recordings from 17 young male normal volunteers (mean age: 22 +/- 3 years). In order to determine the influence of the autonomic nervous system on the rate-dependence of QT, the authors compared the slopes obtained from recordings during the day and the night. Then, the respective rate-dependences of the entire QT interval (QTe) and its initial subdivision (QTa) and their correlations with parameters of heart rate variability were studied.
the QTa/RR and QTe/RR relations were constantly linear, with very significant regression coefficients. The daytime QTa/RR and QTe/RR slopes were significantly steeper than the nighttime ones (0.138 +/- 0.035 vs 0.108 +/- 0.040, p < 0.05 for QTe/RR, 0.160 +/- 0.069 vs 0. 108 +/- 0.055, p < 0.01 for QTa/RR). The early part of QT showed a stronger rate-dependence than the global QT, but only at daytime (0.160 +/- 0.069 vs 0.138 +/- 0.035, p < 0.05). No correlation was found between rate dependences and heart rate variability parameters.
the authors demonstrate, from ambulatory ECG recordings, the influence of the autonomic nervous system on the rate-dependence of ventricular repolarization in normal young adults, and a difference in rate-dependence between the entire QT interval and its initial part QTa, due to differences in autonomic nervous system tone. This heterogeneity should be taken to account in the study of pathological changes or drugs effects on ventricular repolarization.
心室复极持续时间对心率的适应性为QT间期的静态持续时间提供了额外信息。
使用17名年轻男性正常志愿者(平均年龄:22±3岁)的24小时心电图记录来确定QT/RR关系及其斜率。为了确定自主神经系统对QT心率依赖性的影响,作者比较了白天和夜间记录获得的斜率。然后,研究了整个QT间期(QTe)及其初始细分(QTa)各自的心率依赖性及其与心率变异性参数的相关性。
QTa/RR和QTe/RR关系始终呈线性,回归系数非常显著。白天的QTa/RR和QTe/RR斜率明显比夜间的更陡(QTe/RR:0.138±0.035对0.108±0.040,p<0.05;QTa/RR:0.160±0.069对0.108±0.055,p<0.01)。QT的早期部分比整体QT表现出更强的心率依赖性,但仅在白天如此(0.160±0.069对0.138±0.035,p<0.05)。在心率依赖性与心率变异性参数之间未发现相关性。
作者通过动态心电图记录证明了自主神经系统对正常年轻成年人心室复极心率依赖性的影响,以及由于自主神经系统张力的差异,整个QT间期与其初始部分QTa在心率依赖性上的差异。在研究心室复极的病理变化或药物作用时应考虑这种异质性。