血管性シンコープの患者におけるTp- Te区間の予測評価
Xiaomin Zhang1, Shuting Dai2, Haitao Wang2
1Department of Comprehensive Examination, Shanxi Cardiovascular Hospital, YiFen Street NO.18, Taiyuan, 030024, Shanxi, China. Zhang13593156371@163.com.
まとめ
心臓の電気活動を測定するTp-Te区間は,血管縮 (VVS) とそのサブタイプを予測することができます. 高いTp- Te間隔は,VVS患者のヘッド・アップ・ティルト・テスト (HUTT) の陽性反応の可能性が高いことを示しています.
科学分野:
- 心臓病科
- 自律神経系の生理学
- エレクトロカルジオグラフィー
背景:
- 血管縮 (VVS) は,心臓の電気的活動に影響する自律的調節障害によって特徴付けられます.
- トランムラル再極化分散を表すTp-Te区間は,VVSの潜在的な指標である.
- Tp-Teの評価は,VVSの疑いのある症例において,ヘッド・アップ・ティルト・テスト (HUTT) の陽性な結果を予測するのに役立ちます.
研究 の 目的:
- 疑われるVVSの患者におけるベースラインの心電図間隔 (QT,QTc,Tp- Te) とHUTT応答の関連性を調べる.
- Tp-Te区間が陽性HUTT結果を予測し,VVSサブタイプを区別できるかどうかを判断する.
主な方法:
- 疑われるVVS患者179人がHUTTを受けた.
- 患者はHUTT陰性およびHUTT陽性 (血管抑制薬,心臓抑制薬,混合型) に分類された.
- HUTTの前にQT,QTc,Tp- Te間隔をベースラインの12鉛ECGで分析した.
主要な成果:
- HUTT陽性患者は,HUTT陰性患者よりQT,QTc,Tp- Te間隔が有意に高かった (P< 0. 001).
- 血管抑制薬のサブグループと比較して,心臓抑制薬と混合型のサブグループではTp- Te間隔がより高かった (P < 0. 05).
- Tp- Te間隔>88msはHUTTの陽性 (71. 7%の感度,75. 9%の特異性) を予測し,QT/ QTc (P < 0. 05) よりも強い予測因子であった. Tp- Te > 95 ms 予測された心臓阻害性/混合型応答 (75%の感度,57. 1%の特異性).
結論:
- Tp- Te区間によって示されるベースラインの心筋再極化は,VVSの感受性に関連しています.
- Tp-Te区間は,HUTT応答に基づいてVVSサブタイプを区別するための新しい非侵襲的指標として機能します.
- ベースラインのTp- Teの上昇は,VVS患者の心臓抑制反応を予測する可能性があります.
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