Circadian and gender effects on repolarization in healthy adults: a study using harmonic regression analysis.
Circadian and gender effects on repolarization in healthy adults: a study using harmonic regression analysis.
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昼夜节律和性别对健康成年人复极的影响：一项使用谐波回归分析的研究。
DOI：
10.1111/j.1542-474x.2009.00333.x
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Kadish,Alan
中科院分区：
文献类型：
--
作者：
Mayuga,KennethA;Thattassery,Emil;Taneja,Taresh;Karha,Juhana;Subacius,Haris;Goldberger,Jeffrey;Kadish,Alan
背景：心源性猝死和心肌梗死具有昼夜节律变化，发病高峰在清晨。复极离散度的增加促进了诱发持续性心律失常所必需的传导延迟的发展。QT离散度和T波峰至T波末（TpTe）均被认为是心肌复极离散度的标志物。方法：对40名健康成人（20名女性）进行分析，年龄35-67岁，心电图、超声心动图、负荷试验和倾斜试验正常，住院27小时。在8个不同的时间点进行心电图检查。在每个时间点测量QT间期、QT离散度和TpTe。结果：女性复合QT间期长于男性（416 ± 17 msec vs 411 ± 20 msec，P = 0.006）。男性所有导联的QT离散度均大于女性（分别为37 ± 13 msec vs 30 ± 11 msec，P < 0.0001）;心前区导联也存在类似差异。调和回归显示QT离散度具有显著的昼夜变化，主要在男性中。在男性中，最大QT离散度发生在6 AM（45 ± 15 msec）。TpTe也有一个显着的昼夜变化，不受性别的影响，在大多数leads.Conclusions：昼夜变化存在于心肌复极的离散度，测量TpTe和QT离散度。男性和女性有不同的昼夜变化模式。关于其机制和临床意义还需要进一步的研究。Ann Noninvasive Electrocardiol 2010;15（1）：3-10
Background:Sudden cardiac death and myocardial infarction have a circadian variation with a peak incidence in the early morning hours. Increased dispersion of repolarization facilitates the development of conduction delay necessary to induce sustained arrhythmia. Both QT‐dispersion and T‐wave peak to T‐wave end (TpTe) have been proposed as markers of dispersion of myocardial repolarization.Methods:Forty healthy adults (20 women), age 35–67 years old, with normal EKGs, echocardiograms, stress tests, and tilt‐table tests were analyzed during a 27‐hour hospital stay. EKGs were done at eight different time points. QT‐intervals, QT‐dispersion, and TpTe were measured at each time point. Harmonic regression was used to model circadian periodicity, P < 0.05 was considered significant.Results:The composite QT‐interval was longer in women than in men (416 ± 17 msec vs 411 ± 20 msec, respectively, P = 0.006). The QT‐dispersion among all leads was greater in men than women (37 ± 13 msec vs 30 ± 11 msec, respectively, P < 0.0001); a similar difference was found in the precordial leads. Harmonic regression showed that QT‐dispersion had a significant circadian variation, primarily in men. In men, the maximum QT‐dispersion occurred at 6 AM (45 ± 15 msec). TpTe also had a significant circadian variation that was not affected by gender in the majority of leads.Conclusions:A circadian variation exists in the dispersion of myocardial repolarization, as measured by both TpTe and QT‐dispersion. Men and women have a different circadian variation pattern. Further studies regarding the mechanisms and clinical implications are needed.Ann Noninvasive Electrocardiol 2010;15(1):3–10