QTc interval in the assessment of cardiac risk.
QTc interval in the assessment of cardiac risk.
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DOI：
10.1023/a:1016345412555
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发表时间：
2002-09-01
期刊：
影响因子：
--
通讯作者：
Torp-Petersen, Christian
中科院分区：
文献类型：
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作者：
Elming, Hanne;Brendorp, Bente;Torp-Petersen, Christian
仅在美国，每年就有30 -40万人死于心源性猝死。大部分死亡被认为是由室性心动过速引起的。QTc延长反映心脏复极延长和/或复极不均匀性增加，已知与心律失常风险增加有关。本文综述了评估QTc室性心律失常和/或心源性死亡风险的可能性。延长QTc可能对缺血性心脏病和糖尿病等常见疾病的死亡率具有独立的预后重要性，而对心力衰竭和动脉高血压的预后重要性则不太确定。在先天性长QT间期综合征等较为罕见的疾病中，QT间期不仅对诊断有重要的提示作用，而且其大小也为预后提供了信息。QTc在肥厚性心肌病或致心律失常的右室疾病中可能没有独立的预后重要性。QTc延长药物治疗期间QTc延长程度是室性心律失常风险的预后指标，QTc延长药物对于QTc大于460 ms的患者可能不应开处方，治疗期间QTc超过500 ms的患者应停用QTc延长药物。DIAMOND研究的数据表明，QTc可用于指出那些将受益于抗心律失常治疗的心力衰竭患者。
In the United States alone 300,000-400,000 people die of sudden cardiac death every year. Much of this mortality is assumed to be caused by ventricular tachyarrhythmias. Prolonged QTc reflect cardiac repolarization prolongation and/or increased repolarization inhomogenity known to be associated with increased risk of arrhythmias. The paper gives a review of the possibilities to assess the risk of ventricular arrhythmia and/or cardiac death from QTc. Prolonged QTc may hold independent prognostic importance for mortality in common diseases as ischemic heart disease and diabetes mellitus where as the prognostic importance in heart failure and arterial hypertension is more uncertain. In more rare diseases as the inborn long QT syndrome the QT interval gives not only important hint to the diagnosis but the magnitude also provides information on prognosis. QTc has probably no independent prognostic importance in hypertrophic cardiomyopathy or in the arrhythmogenic right ventricular disease. The degree of QTc prolonging during treatment with QTc prolonging drugs is prognostic for the risk of ventricular arrhythmia in form of torsade de pointes and QTc prolonging drugs should probably not be prescribed for patients with a QTc greater than 460 ms and withdrawn if QTc exceeds 500 ms during treatment. Data from the DIAMOND study suggest that QTc can be used to point out those heart failure patients who will benefit from antiarrhythmic therapy.