QT-interval duration and mortality rate: results from the Third National Health and Nutrition Examination Survey.
QT-interval duration and mortality rate: results from the Third National Health and Nutrition Examination Survey.
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DOI：
10.1001/archinternmed.2011.433
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发表时间：
2011-10-24
影响因子：
--
通讯作者：
Guallar, Eliseo
中科院分区：
文献类型：
--
作者：
Zhang, Yiyi;Post, Wendy S.;Dalal, Darshan;Blasco-Colmenares, Elena;Tomaselli, Gordon F.;Guallar, Eliseo
QT间期的极端延长或缩短使患者易患恶性室性心律失常和心脏性猝死，但在普通人群中，QT间期在参考范围内的变异与死亡终点的相关性尚不清楚。我们纳入了来自第三次全国健康与营养检查调查的7828名男性和女性。通过标准12导联心电图读数测量基线QT间期。2006年12月31日前对死亡率终点进行了评估(2291例死亡)。平均随访13.7年后，QT间期与死亡率终点之间的关系呈U型。将年龄、性别、种族和R-R间期校正后的QT间期(≥439毫秒)第95个百分位数或以上的参与者与中间五分之一的参与者(401%到<；总死亡率为2.03(95%可信区间，1.46-2.81)，心血管疾病死亡率为2.55(1.59-4.09)，冠心病死亡率为1.63(0.96-2.75)，非心血管疾病死亡率为1.65(1.16-2.35)。校正QT间期低于第五百分位数(<；377毫秒)的参与者与校正后的五分位数参与者相比，总死亡率为1.39(95%可信区间，1.02-1.88)，心血管死亡率为1.35(0.77-2.36)，冠心病死亡率为1.02(0.44-2.38)，非心血管死亡率为1.42(0.97-2.08)。死亡率也有所增加，QT间期的偏差也较小。Bazett校正的QT间期也观察到类似的，尽管较弱的相关性。QT间期的缩短和延长，即使在参考范围内，也与普通人群中死亡风险的增加有关。
Extreme prolongation or reduction of the QT interval predisposes patients to malignant ventricular arrhythmias and sudden cardiac death, but the association of variations in the QT interval within a reference range with mortality end points in the general population is unclear. We included 7828 men and women from the Third National Health and Nutrition Examination Survey. Baseline QT interval was measured via standard 12-lead electrocardiographic readings. Mortality end points were assessed through December 31, 2006 (2291 deaths). After an average follow-up of 13.7 years, the association between QT interval and mortality end points was U-shaped. The multivariate-adjusted hazard ratios comparing participants at or above the 95th percentile of age-, sex-, race-, and R-R interval–corrected QT interval (≥439 milliseconds) with participants in the middle quintile (401 to <410 milliseconds) were 2.03 (95% confidence interval, 1.46-2.81) for total mortality, 2.55 (1.59-4.09) for mortality due to cardiovascular disease (CVD), 1.63 (0.96-2.75) for mortality due to coronary heart disease, and 1.65 (1.16-2.35) for non-CVD mortality. The corresponding hazard ratios comparing participants with a corrected QT interval below the fifth percentile (<377 milliseconds) with those in the middle quintile were 1.39 (95% confidence interval, 1.02-1.88) for total mortality, 1.35 (0.77-2.36) for CVD mortality, 1.02 (0.44-2.38) for coronary heart disease mortality, and 1.42 (0.97-2.08) for non-CVD mortality. Increased mortality also was observed with less extreme deviations of QT-interval duration. Similar, albeit weaker, associations also were observed with Bazett-corrected QT intervals. Shortened and prolonged QT-interval durations, even within a reference range, are associated with increased mortality risk in the general population.
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影响因子：
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作者：
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