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在Fontan手术后晚期的机电相互作用:P波持续时间和分散,右心房大小和心房失常之间的关系
Tom Wong1, Periklis A Davlouros, Wei Li
1Adult Congenital Heart Programme, Department of Cardiology, Royal Brompton Hospital, Sydney Street, London, W3 6NP, UK.
Circulation
|May 12, 2004
概括
患有Fontan循环和心房节拍不良的成年人表现出延长的P波持续时间和分散,以及右心房扩大. 这些电气和结构变化相互连接,表明潜在的机电改造有助于心律失常风险.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 丰坦手术是复杂的先天性心脏缺陷的救命手术.
- 丰坦手术的成年幸存者面临着心房动脉节律失常的重大风险.
- 了解这些心律失常的潜在机制对于改善长期结果至关重要.
研究的目的:
- 调查Fontan患者心房电气特性和尺寸的差异,有和没有心房动脉节律失常.
- 探索心房结构变化和电气异常之间的关系.
- 为了确定这种人群中心律失常发展的潜在预测因素.
主要方法:
- 研究了33名成年Fontan循环患者和20名健康对照.
- 使用心声回声学评估心房尺寸.
- 通过12导心电图测量P波持续时间和分散.
- 在Fontan患者之间比较数据,有和没有心房节拍不良的病史.
主要成果:
- 丰坦患者的P波持续时间和分散时间比对照组更长.
- 与没有心房动脉节律障碍的Fontan患者相比,P波持续时间和分散时间明显更长.
- 患有心房节拍不良的患者也有更大的右心房尺寸.
- P波持续时间和分散与右心房大小有显著的相关性.
结论:
- 在Fontan幸存者的心房节拍不良与P波持续时间的延长,P波分散的增加和右心房的扩大有关.
- 这些发现表明心房的机电改造过程有助于心律失常的易感性.
- 需要进一步的研究来阐明这些机制,并指导临床管理.
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