T波峰-末间期对肥厚型心肌病患者心室复极离散度评价的研究

Evaluation of the Tpeak-Tend interval to the dispersion of ventricular repolarization in hypertrophic cardiomyopathy

关键词:  T波峰-末间期  心室复极离散度  肥厚型心肌病

Key words:  Tpeak-Tend interval  dispersion of repolarization  hypertrophic cardiomyopathy

摘要:

［目的］分析肥厚型心肌病患者T波峰-末间期（Tpeak-Tend interval，Tpe）的特点，探讨Tpe在评价心室复极离散度中的意义。［方法］对已确诊的原发性肥厚型心肌病21例及正常人19例进行回顾性分析。测量体表心电图12个导联的Tpe和QT间期离散度（dispersion of QT interval，QTd），T波低平的导联除外，计算Tpe平均值校正值（Tpe-AVEC）、Tpe最大值校正值（Tpe-MAXC）、V1导联Tpe校正值 （Tpe-V1C）、V5导联Tpe校正值（Tpe-V5C）、Ⅱ导Tpe校正值（Tpe-ⅡC）。比较上述各参数在肥厚型心肌病与正常人之间的差异。［结果］肥厚型心肌病组与正常对照组比较：Tpe-AVEC（91.3±13.1）vs （2.7±10.0），P=0.026、Tpe-MAXC（154.7±31.5）vs （19.2±11.6），P=0、Tpe-ⅡC（93.6±34.1）vs （2.5±13.5），P=0.017、QTd （59.1±21.3）vs （9.7±17.0），P=0.003、Tpe-V1C（94.6±26.2）vs （7.2±21.2），P=0.382、Tpe-V5C（89.0±20.9）vs （6.9±12.7），P= 0.704。肥厚型心肌病组Tpe-AVEC、Tpe-MAXC、Tpe-ⅡC、QTd 与正常对照组比较差异有显著性意义（P<0.05），而Tpe-V1C、Tpe-V5C与正常对照组比较差异无显著性意义。［结论］Tpe反映心室整体复极离散度的可能性大。在Tpe测量中建议选用Tpe-AVE、Tpe-MAX和Tpe-Ⅱ，可能更适用于评价该类患者的心室复极离散。

Abstract:

［Objective］This study aims to evaluate the characteristics of the Tpeak-Tend interval (Tpe) in patients with and without hypertrophic cardiomyopathy (HCM).［Method］Forty patients were enrolled in this study,which included 21 patients with primary HCM and 19 without structural heart disease.The Tpe and the dispersion of QT interval (QTd) from the 12 lead surface ECG were acquired and measured manually in all of the patients in the two groups,and consequently the corrected numerals of the average of Tpe,the maximal Tpe,the Tpe of lead V1,V5, Ⅱ were calculated,which was named as Tpe-AVEC,Tpe-MAXC,Tpe-V1C,Tpe-V5C and Tpe-ⅡC respectively.The corrected numerals and QTd were then compared between the group HCM and control.［Results］The comparisons between the group HCM and control were Tpe-AVEC(91.3±13.1) vs (2.7±10.0),P=0.026,Tpe-MAXC(154.7±31.5) vs (19.2±11.6),P=0,Tpe-ⅡC(93.6±34.1) vs (2.5±13.5),P=0.017,QTd (59.1±21.3) vs (9.7±17.0),P=0.003,Tpe-V1C(94.6±26.2) vs (7.2±21.2),P=0.382, Tpe-V5C(89.0±20.9) vs (6.9±12.7), P=0.704. Compared to group control, the Tpe-AVEC, Tpe-MAXC, Tpe-ⅡC and QTd of group HCM appeared significant differences (P<0.05).However,no significant differences were found in Tpe-V1C and Tpe-V5C in the two groups.［Conclusion］Tpe might represent the global,but not the transmural dispersion of ventricular repolarization.Tpe-AVE,Tpe-MAX and Tpe-Ⅱare recommended to be used for evaluation of the ventricular repolarization dispersion as the prognostic index in patients with HCM.