Puljevic D, Smalcelj A, Durakovic Z, Goldner V
Clinic for Cardiovascular diseases, Rebro, Zagreb, Croatia.
Eur Heart J. 1997 Aug;18(8):1343-9. doi: 10.1093/oxfordjournals.eurheartj.a015448.
The aim of the study was to determine the value and correlation between QT dispersion, daily variations in the QT interval and late potentials as risk markers for ventricular tachycardia.
QT dispersion was defined as the difference between the longest and the shortest QT interval in 12 electrocardiographic leads, QTc variability as the difference between the maximal and minimal QTc interval during 24-h Holter monitoring and QT interval adaptation as the regression line between heart rate and the uncorrected QT interval. One hundred and forty-five patients, 3 months after myocardial infarction were included in the study. QT dispersion significantly increased with the severity of arrhythmia (modified Lown's classification; P< 0.001). The level of 80 ms was associated with ventricular tachycardia with a sensitivity of 72.7% and a specificity of 86.4%. The greater daily variability of the QTc interval in patients with ventricular tachycardia was insignificant (P > 0.05). QT interval adaptation did not discriminate between patients with ventricular tachycardia from those in other groups. Late potentials were associated with ventricular tachycardia with a sensitivity of 50% and a specificity of 90.3%.
Large QT dispersion and late potentials were risk markers for ventricular tachycardia, but there was no correlation between QT dispersion, daily variations in the QT interval and late potentials in patients 3 months after myocardial infarction.
本研究旨在确定QT离散度、QT间期的每日变化以及晚电位作为室性心动过速风险标志物的价值及相关性。
QT离散度定义为12导联心电图中最长与最短QT间期之差,QTc变异性定义为24小时动态心电图监测期间最大与最小QTc间期之差,QT间期适应性定义为心率与未校正QT间期之间的回归线。本研究纳入了145例心肌梗死后3个月的患者。QT离散度随心律失常严重程度(改良的洛恩分类法;P<0.001)显著增加。80毫秒的水平与室性心动过速相关,敏感性为72.7%,特异性为86.4%。室性心动过速患者QTc间期的每日变异性较大无统计学意义(P>0.05)。QT间期适应性在室性心动过速患者与其他组患者之间无鉴别意义。晚电位与室性心动过速相关,敏感性为50%,特异性为90.3%。
QT离散度增大和晚电位是室性心动过速的风险标志物,但在心肌梗死后3个月的患者中,QT离散度、QT间期的每日变化与晚电位之间无相关性。