Detection of Peripartum Myocardial Burden by Vector-Projected 187 Channel Electrocardiography and Serum NT-proBNP
Detection of Peripartum Myocardial Burden by Vector-Projected 187 Channel Electrocardiography and Serum NT-proBNP
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DOI：
10.1536/ihj.54.140
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发表时间：
2013-05-01
影响因子：
1.5
通讯作者：
Sugiyama, Toru
中科院分区：
文献类型：
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作者：
Terata, Miyuki;Nakai, Kenji;Sugiyama, Toru
目前还没有可靠的方法来筛查发生严重心肌疾病的高危孕妇。在这项研究中，我们使用向量投影187通道心电图（DREAM-ECG）和血清生化指标来评估孕妇围产期心肌负荷。41名孕妇分别在妊娠36-37周（GW36）、产后7天（PPD7）和产后1个月（PPM1）进行了检查。在一个时间点对10名未怀孕的对照妇女进行评估。采用DREAM-ECG系统量化心率、交感神经指数和复极指数（RTc弥散度），测定血清NT-proBNP、心肌肌钙蛋白T、雌激素和孕酮水平。心率和交感神经指数从GW36到PPM1下降（P = 0.0031）。复极指数随着时间的推移而下降，并大于未怀孕对照组（31 +/- 13 ms）。PPD7和PPM1的雌激素和孕激素水平显著低于GW36 （P < 0.0001, P < 0.001）。PPD7时NT-proBNP高于GW36时（GW36时中位数为29 pg/mL， PPD7时为86 pg/mL）， PPM1时NT-proBNP低于PPD7时（中位数为18.5 pg/mL）。肌钙蛋白T在整个过程中处于正常范围(
There is no reliable method of screening for pregnant women at high risk of developing severe myocardial disorders. In this study, we used vector-projected 187 channel electrocardiography (DREAM-ECG) and serum biochemical markers to evaluate peripartum myocardial burden in pregnant women. Forty-one pregnant women were examined at 36-37 weeks gestation (GW36), 7 days postpartum (PPD7), and 1 month postpartum (PPM1). Ten non-pregnant control women were assessed at a single time point. Heart rate, sympathetic index, and repolarization index (RTc dispersion) were quantified using the DREAM-ECG system, and serum levels of NT-proBNP, cardiac troponin T, estrogen, and progesterone were determined. Heart rate and the sympathetic index decreased from GW36 to PPM1 (P = 0.0031). The repolarization index decreased over time and was greater than in non-pregnant controls (31 +/- 13 ms). Estrogen and progesterone at PPD7 and PPM1 were significantly lower than those at GW36 (P < 0.0001, P < 0.001). NT-proBNP at PPD7 was greater than at GW36 (median 29 pg/mL at GW36, 86 pg/mL at PPD7), and decreased at PPM1 in comparison to PPD7 (median 18.5 pg/mL). Troponin T was in the normal range during the whole period (