Sex differences in the evolution of the electrocardiographic QT interval with age.
Sex differences in the evolution of the electrocardiographic QT interval with age.
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发表时间：
1992-09
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通讯作者：
P. Rautaharju;S. H. Zhou;S. Wong;H. Calhoun;G. Berenson;R. Prineas;A. Davignon
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作者：
P. Rautaharju;S. H. Zhou;S. Wong;H. Calhoun;G. Berenson;R. Prineas;A. Davignon
目的探讨QT间期随年龄变化的性别差异。受试者和方法：以社区为基础的代表性北美人口样本的14，379名儿童和成人，年龄从出生到75岁。通过计算机算法确定测量的QT间期（QTm），并将根据心率（HR）校正的QTm表示为QT指数：QTI =（QTm/Tp）× 100，其中QTp是根据公式QTp（ms）= 656/（1 + HR/100）预测的QT。主要结果在15 ~ 50岁各年龄组中，女性QTI值均显著长于男性。这种差异是由于青春期后的青少年男性的心率校正QT值下降20 ms，而女性的QT值在整个生长、成熟和生育期保持不变。在调整心率和观察到的心室兴奋时间（QRS持续时间）对两种性别QT间期的显著影响以及对男性QT年龄趋势的校正后，新的QT预测公式解释了女性总QT变异的83%和男性的82%。结论：QT间期的性别差异是由于青春期后男性的QT缩短，而不是生育期女性的QT延长。QRS时限是QT间期的重要决定因素，这一事实对心室复极过程建模具有重要的理论意义，并表明心室复极逆序的传统概念并不适用于所有心肌区域。
OBJECTIVE To investigate sex differences in the evolution of the QT interval with age. SUBJECTS AND METHODS A community-based representative North American population sample of 14,379 children and adults aged from birth to 75 years. The measured QT intervals (QTm) were determined by a computer algorithm and QTm, corrected for heart rate (HR), was expressed as QT index: QTI = (QTm/Tp) x 100, where QTp is the predicted QT from the formula QTp (ms) = 656/(1 + HR/100). MAIN RESULTS The QTI values of females were significantly longer than of males in all age groups from 15 to 50 years tested at yearly intervals. This difference was due to a 20 ms drop in rate-corrected QT values in adolescent males after puberty, whereas QT values of females remained unchanged throughout the growth, maturation and reproductive years. The new QT prediction formula explained 83% of total QT variance in females and 82% in males after adjustment for heart rate and for the observed significant influence of ventricular excitation time (QRS duration) on QT interval in both sexes and a correction for QT age trend in males. CONCLUSIONS The sex difference in the QT interval is due to QT shortening in males after puberty rather than QT prolongation in women during reproductive years. The fact that QRS duration is a significant determinant of the QT interval has important theoretical implications for attempts to model the ventricular repolarization process and it indicates that the traditional concept of reverse sequence of ventricular repolarization is not universally valid in all myocardial regions.