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長いQT症候群の胎児心拍の予測要因
Jason L Mitchell1, Bettina F Cuneo, Susan P Etheridge
1The Heart Institute for Children, Hope Children's Hospital, 4440 W 95th Street, Oak Lawn, IL 60453, USA.
Circulation
|November 6, 2012
まとめ
胎児長QT症候群 (LQTS) は,特に胎児の心拍数が妊娠年齢の3番目の百分位以下である場合,しばしばシヌスブラジカルディアと関連付けられています. この発見は,胎児と家族のLQTSを診断するのに役立ちます.
科学分野:
- 心臓病学 心臓病学
- 遺伝学 遺伝学とは
- 胎児医学 胎児医学について
背景:
- 胎児長QT症候群 (LQTS) は,トーサード・ド・ポインテス (torsades de pointes) や心房閉塞 (atrioventricular block) などの複雑な不律を起こすことで知られています.
- シヌスブラジカルディアは胎児のLQTSとも関連しているが,その特徴はまだよくわかっていない.
研究 の 目的:
- 長期QT症候群 (LQTS) と診断された胎児の胎児心拍数 (FHR) と妊娠年齢 (GA) プロフィールを特徴付けるため.
主な方法:
- 胎児のLQTS症例は,家族歴または胎児不律症の紹介を通じて特定されました.
- LQTS被験者の胎児心拍数 (FHR) は,正常な胎児の心拍数と比較した.
- ブラジカルディア指数は,LQTS FHR記録の110bpm以下またはGAの3番目の百分位を下回る割合を決定するために計算されました.
主要な成果:
- 42人のLQTS被験者のうち,66%がGAの3パーセント以下でFHRを示しており,110bpm以下は15%に過ぎなかった.
- 複合性不律症の10人の胎児は,妊娠中の重症で持続的なシヌスブラジカルディアも示した.
- 胎児不律症の紹介経由でプロンバンドを診断することで,これまで疑われていなかった9人の家族のLQTSが特定されました.
結論:
- 胎児の心拍数 (FHR) のパターンは,正常胎児とLQTS胎児の間で異なっており,妊娠年齢 (GA) に応じて変化します.
- GAの3番目の百分位未満のFHRを持つ新生児の産後評価は,胎児,新生児,およびその家族のLQTSの検出を向上させることができます.
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