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使用修正的QT间隔预测药物诱导的Torsade De Pointes风险的最佳心电图:一个比较的预后研究
Tharathorn Raicharoen1, Suphaphorn Vassasunthorn1, Rittirak Othong1
1Department of Emergency Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Dusit, Bangkok, Thailand, 10300.
电心电图 (ECG) 上最长的QT间隔 (QTc) 最好预测药物诱导的Torsade de pointes (TdP). 一个3个的平均QTc提供了类似的预测准确性与更少的努力.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 尖胸部 (Torsade de pointes,TdP) 是一种危及生命的心律失常,与药物诱导的QT延长有关.
- 电心电图 (ECG) 线索显示不同的QT间隔长度,可能会影响TdP预测的准确性.
研究的目的:
- 确定最佳的心电图线索或线索组合,以预测药物诱导的TdP.
- 为了比较不同心电图导线和QTc测量方法的预后准确性.
主要方法:
- 一项涉及TdP病例和对照的比较预后准确性研究.
- 计算和比较接收器操作特征曲线 (AUROC) 下的区域,用于各种单个和组合的心电图导线的心率校正QT (QTc) 间隔.
- 由四名研究人员进行的QTc测量具有高interrater可靠性 (0.95).
主要成果:
- 在任何线索中,最长的QTc间隔显示了TdP预测的最高AUROC,而不管使用的QTc校正公式.
- V3经常在单个中表现出最长的QTc间隔.
- 3个线索的平均QTc (线索II加上V2-V4中的任何两个) 和6个线索的中位数QTc显示了可比的TdP预测性能.
结论:
- 最长的QTc间隔是药物诱导TdP的强有力的预测指标,但它的位置因患者而异.
- 从3个特定的潜在客户获得的平均QTc提供了具有类似预测性能的实用替代方案.
- 需要进行前性研究来验证这些发现的临床实用性.
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