ホルター記録に刻まれたT波は,LQt2 (HERG) 変異を有する患者の検出を強化します
J M Lupoglazoff1, I Denjoy, M Berthet
1Cardiologie, Hôpital Robert Debré, Paris, France. jean-marc.lupoglazof@rdb.ap-hop-paris.fr
Circulation
|February 27, 2001
まとめ
ホルター心電図に刻まれたT波は,HERG変異によって引き起こされるロングQT症候群 (LQTS) 2型 (LQT2) の重要な指標である. ホルター分析は,これらの再極化異常を標準的なEKGよりもよく検出し,LQT2とLQT1.1を区別します.
科学分野:
- 心臓病学 心臓病学
- 遺伝学 遺伝学とは
- エレクトロカーディオグラフィーです.
背景:
- 支配的な長QT症候群 (LQTS) は,通常,心臓のカリウムチャネルをコードするKCNQ1 (LQT1) とHERG (LQT2) 遺伝子の変異によって引き起こされます.
- 切断されたT波は,QT間隔の延長とともに,LQTS患者のために提案されたフェノタイプのマーカーです.
研究 の 目的:
- KCNQ1 (LQT1) とHERG (LQT2) 変異の患者および健康な対照群におけるT波形態の分析.
- ホルター心電図の記録と,T波のを検出する標準の12リード心電図の診断の有用性を比較する.
主な方法:
- T波の形状は,LQT1キャリア133人,LQT2キャリア57人,および対照100人のHolter ECG記録から分析されました.
- 割れ目のあるT波は,水平線に対する形状学に基づいて,グレード1 (G1) とグレード2 (G2) に分類されました.
- 平均T波のテンプレートは,様々な心循環の長さで生成されました.
主要な成果:
- T波形態は,ほとんどのLQT1 (92%) と対照群 (96%) の被験者に正常であったが,LQT2の被験者のわずか19%に異常であった.
- グレード1 (G1) のノッチは,LQT1 (8%) と対照群 (4%) に比べてLQT2 (18%) でより頻繁に見られた.
- グレード2 (G2) のノッチは,LQT2患者 (63%) のみで観察され,予測要因には,若い年齢,ミスセンスの変異,HERGコアドメイン変異が含まれています.
結論:
- ホルター記録分析は,G1とG2のT波のノッチを検出するために,12リードのECGよりも優れています.
- T波のノッチ,特にG2は,LQT1よりもLQT2の兆候である.
- G2のノッチはLQT2に特異性があり,しばしば特定のHERG遺伝子変異と関連しています.
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