非冠状动脉心脏病的突然死亡与延迟的节奏室内激活有关
Richard C Saumarez1, Lidia Chojnowska, Richard Derksen
1Department of Cardiology, Papworth Hospital, University of Cambridge, Cambridge CB3 8RE, UK. rcs23@eng.cam.ac.uk
Circulation
|May 14, 2003
概括
延迟心肌激活是非冠心病患者心室动 (VF) 风险的关键指标. 评估电图持续时间的变化可以帮助预测VF的发生.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 心室动 (VF) 的风险与心肌激活减缓和分散的折射性有关.
- 腹腔电图持续时间 (DeltaED) 和S1S2延迟的增加在风险为VF的高性心肌病 (HCM) 患者和异常性VF (IVF) 患者中观察到.
研究的目的:
- 研究非冠状动脉心脏病患者中心肌激活延迟和VF病史之间的关系.
- 评估电图持续时间变化作为风险预测器的潜力.
主要方法:
- 节奏电图分数分析用于测量DeltaED和S1S2延迟在266名患有非冠状动脉心脏病的患者中.
- 患者被分为那些有VF病史 (n=61) 和那些没有 (非VF组,n=205) 的患者,包括HCM,IVF,LQTS和DCM的子组. 还包括一个没有心脏病的对照组 (n=12).
主要成果:
- 与非VF患者相比,患有VF病史的患者在包括HCM,DCM和LQTS在内的各种疾病中表现出明显更长的DeltaED和S1S2延迟 (P<0.001).
- 在HCM VF患者中,DeltaED为19+/-3.3毫秒,S1S2延迟为350+/-9.7毫秒,与非VF患者形成鲜明对比 (DeltaED为7.3+/-1.35毫秒;S1S2延迟为312+/-6.7毫秒).
- 试管婴儿患者呈现异质心肌区域,显示严重异常和正常区域.
结论:
- 缓慢或延迟的心肌激活是非冠状动脉心脏病患者有VF病史的普遍特征.
- 对心肌激活延迟的评估可能为预测这些患者群体的风险提供一种方法.
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