Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation.
Pretransplant-corrected QT dispersion as a predictor of pericardial effusion after pediatric hematopoietic stem cell transplantation.
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移植前校正的 QT 离散度作为儿科造血干细胞移植后心包积液的预测因子。
DOI：
10.1111/tri.12532
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发表时间：
2015
影响因子：
3.1
通讯作者：
Yasukochi S
中科院分区：
文献类型：
--
作者：
Yanagisawa R;Ishii E;Motoki N;Yamazaki S;Morita D;Sakashita K;Shiohara M;Tanaka M;Hidaka Y;Kubota N;Hidaka E;Ogiso Y;Nakamura T;Yasukochi S
心包积液是造血干细胞移植（HSCT）后潜在的致命并发症。因此，识别风险因素可以改善结果。 QT 离散度 (QTD) 和校正 QTD (QTcD) 延长与多种心脏病中的严重心律失常和猝死有关。然而，尚无研究评估 QTD 和 QTcD 预测 HSCT 后心包积液的功效。我们研究了 89 名儿童 HSCT 患者，以确定心包积液的术前危险因素，特别关注 QTD 和 QTcD。 HSCT后一年内有15例患者（累计发病率为17.4%）出现心包积液，其中8例（9.2%）有症状。同种异体 HSCT 后出现心包积液的患者总体生存率显着降低；然而，心包积液并不是任何患者死亡的直接原因。单变量和多变量分析显示，移植相关血栓性微血管病（TA-TMA）是 HSCT 后心包积液的独立危险因素。此外，心包积液组的移植前 QTcD 显着延长。这些结果表明，在 HSCT 准备方案前 QTcD 异常延长的儿科患者应定期进行超声心动图随访，以检测心包积液，特别是当伴有 TA-TMA 等并发症时。
Pericardial effusion is a potentially fatal complication following hematopoietic stem cell transplantation (HSCT). Therefore, the identification of risk factors could improve the outcome. Prolonged QT dispersion (QTD) and corrected QTD (QTcD) are associated with serious arrhythmias and sudden death in many forms of heart disease. However, no study has evaluated the efficacy of QTD and QTcD to predict pericardial effusion post‐HSCT. We studied 89 pediatric HSCT patients to identify preoperative risk factors for pericardial effusion with particular focus on QTD and QTcD. Pericardial effusion occurred in 15 patients (cumulative onset rate: 17.4%) within one year post‐HSCT, of which 8 (9.2%) were symptomatic. Patients with pericardial effusion following allogeneic HSCT showed significantly lower overall survival; however, pericardial effusion was not the direct cause of death in any patient. Univariate and multivariate analyses revealed that transplantation‐associated thrombotic microangiopathy (TA‐TMA) was an independent risk factor for post‐HSCT pericardial effusion. In addition, pretransplant QTcD was significantly prolonged in the pericardial effusion group. These results suggest that pediatric patients with abnormally prolonged QTcD before the preparative regimen for HSCT should be regularly followed‐up by echocardiography to detect pericardial effusion, particularly when accompanied by complications including TA‐TMA.