P波和QT间期离散度对先天性心脏病伴肺动脉高压患儿心律失常发生的预测价值

2020
10/09

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米勒之声
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PWD和QTd均是PAH-CHD患儿发生各种心律失常的良好预测指标。


 本文由“罂粟花”授权转载

Evaluation of ventricular repolarization parameters during migraine attacks

背景与目的

本研究旨在评估先天性心脏病肺动脉高压(PAH-CHD患儿P波离散度(PWD)和QT离散度(QTd),并研究PWDQTd用于预测此类儿童发生心律失常的价值。

方  法

我们将40名患有PAH-CHD的儿童纳入  将另外40名患有CHDPAH的儿童纳入  组。年龄和性别相匹配的四十名健康儿童作为对照组。进行心电图检查测量PWDQTd。此外,进行24小时动态心电图监测以检测心律不齐。进行超声心动图评估。

结 果  

I组的QTdPWD显着高于II组和对照组。QTdPWD与平均肺动脉压右心室直径肺血管阻力(PVRPVR全身血管阻力的比值均呈显着正相关。QTd预测PAH-CHD患儿心律失常发生的临界值为61 ms,灵敏度为93%特异度为80%准确率为85%PWD预测PAH-CHD患儿心律失常发生的临界值为32.5 ms,灵敏度为87%特异度为80%准确率为85%逻辑回归分析显示,QTdPWD都是PAH-CHD儿童心律失常发生的良好预测指标(p = 0.003p = 0.01)。


 


结 论

PWDQTdPAH-CHD患儿发生各种心律失常的良好预测指标




原始文献来源及摘要

Saleh A, Shabana A, EI Amrousy D, et al. Predictive value of P-wave and QT interval dispersion in children with congenital heart disease and pulmonary arterial hypertension for the occurrence of arrhythmias.[J].J Saudi Heart Assoc,2019 ,31(2):57-63.

Objectives:

To evaluate P-wave dispersion (PWD) and QT dispersion (QTd) in children with congenital heart disease and pulmonary arterial hypertension (PAH-CHD) and to investigate the predictive value of both PWD and QTd for prediction of arrhythmias in such children.

Materials and methods:

We included 40 children with PAH-CHD as Group I. Forty other children with CHD and no PAH were included as Group II. Forty healthy children of matched age and sex served as a Control group. Electrocardiography was performed to determine PWD and QTd. Furthermore, 24-hour Holter monitoring was performed to detect the presence of arrhythmias. Echocardiographic evaluation was also performed.

Results:

QTd and PWD were significantly higher in Group I than in Group II and Control group. A significant positive correlation was present between both QTd and PWD and mean pulmonary artery pressure, right ventricular diameter, pulmonary vascular resistance (PVR), and PVR to systemic vascular resistance ratio. QTd showed 93% sensitivity, 80% specificity, and 85% accuracy for prediction of occurrence of arrhythmias in patients with PAH-CHD at a cutoff point of 61 ms, whereas PWD showed 87% sensitivity, 80% specificity, and 85% accuracy for prediction of arrhythmias at a cutoff point of 32.5 ms in such patients. Logistic regression analysis showed that both QTd and PWD were good predictors for the occurrence of arrhythmias in children with PAH-CHD (p = 0.003 and p = 0.01, respectively).

Conclusions:

PWD and QTd were good predictors for the occurrence of various arrhythmias in children with PAH-CHD.

  

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本微信公众平台所刊载原创或转载内容不代表米勒之声的观点或立场。文中所涉及药物使用、疾病诊疗等内容仅供参考。

本文由作者自行上传,并且作者对本文图文涉及知识产权负全部责任。如有侵权请及时联系(邮箱:guikequan@hmkx.cn
关键词:
肺动脉高压,心律失常,离散度,心脏病,先天性,预测,儿童

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