静脈の脱極化-再極化の分散:不律性右静脈心筋病変におけるリスク層分化の非侵襲的マーカー
P Turrini1, D Corrado, C Basso
1Department of Pathology, University of Padua Medical School, Padua, Italy.
Circulation
|June 27, 2001
まとめ
QRSの分散は,心律不振性右心室性心筋病変 (ARVC) の突然死の最も強い予測因子である. シンコープやQT分散などの他の要因も,ARVC患者のリスクの階層化に役立ちます.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 遺伝的な心疾患 遺伝的な心疾患
背景:
- アリズム発生性右心室性心筋病変 (ARVC) は,突然の心臓死亡の重要な原因です.
- ARVC患者の突然死に関する信頼性の高い予測要因を特定することは,リスクの階層化にとって極めて重要です.
研究 の 目的:
- ARVC患者における突然死のリスクに関するQTおよびQRS分散を含む臨床および心電図 (ECG) 発見の予測価値を評価する.
主な方法:
- ARVC患者 (突然死,持続心室性短拍,非持続心室性不律) と対照群からのECGの遡及分析.
- QTインターバルとQRS複合体の持続時間および変動性の手動測定.
- 突然死亡の独立した予測要因を特定するための多変量分析.
主要な成果:
- QRS分散とQT分散は,ARVC患者,特に突然死を経験した患者において,著しく高かった.
- QRS分散 (>=40 ms) は,突然死を予測するための90%の感度と77%の特異性を示しました.
- 陰性T波のV以上 ((1)) と昏睡は,突然死被害者においてより頻繁であった.
結論:
- QRS分散は,ARVCにおける突然死の強力な独立した予測因子である.
- 失眠,QT分散 (>65 ms),Vを超えた負のT波は,ARVC患者における不律性リスクの階層化をさらに強化する.
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