Microvolt T wave alternans in human cardiac hypertrophy: Electrical instability and abnormal myocardial arrangement
Microvolt T wave alternans in human cardiac hypertrophy: Electrical instability and abnormal myocardial arrangement
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DOI：
10.1046/j.1540-8167.2001.00759.x
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发表时间：
2001-07-01
影响因子：
2.7
通讯作者：
Shirato, K
中科院分区：
文献类型：
--
作者：
Kon-No, Y;Watanabe, J;Shirato, K
简介：虽然T波电交替（TWA）是一个很有前途的心肌电不稳定的风险标志，目前还不清楚如何TWA的存在与心肌damage.Methods和结果：TWA测定28例肥厚型心肌病（HCM），29例高血压左室肥厚（HLVH），和15名正常志愿者使用CH 2000系统。在具有最大振幅的电极导线处测量TWA的振幅（Valt）。对12例HCM患者进行了心脏活检，根据心肌紊乱和纤维化的组织学结果将其分为两组（重度和轻度）。TWA呈阳性（Valt > 1.9 μ V）在61%的HCM和31%的HLVH中，尽管左心室质量指数几乎相同（176 +/- 65 g/m2 vs 175 +/- 39 g/m2）心率= 110次/min时，HCM伴严重紊乱和纤维化患者的Valt显著高于HCM伴轻度紊乱和HLVH患者，结论：在HCM患者中，TWA试验阳性可能与心肌排列异常（紊乱）和/或纤维化有关，并可能反映心肌电不稳定性。
Introduction: Although T wave alternans (TWA) is a promising risk marker for myocardial electrical instability, it remains unclear how the presence of TWA is related to myocardial damage.Methods and Results: TWA was measured in 28 patients with hypertrophic cardiomyopathy (HCM), 29 patients with hypertensive left ventricular hypertrophy (HLVH), and 15 normal volunteers using a CH2000 system. The amplitude of TWA (Valt) was measured at the lead with the maximum amplitude. Cardiac biopsy was performed in 12 HCM patients, who were divided into two groups (severe and mild) based on histologic findings of myocardial disarray and fibrosis. TWA was positive (Valt > 1.9 muV) in 61% of HCM and 31% of HLVH, despite a nearly identical left ventricular mass index (176 +/- 65 g/m(2) vs 175 +/- 39 g/m(2)) Valt at heart rate = 110 beats/min was significantly greater in HCM with severe disarray and fibrosis than in HCM with mild disarray and in HLVH,Conclusion: In HCM patients, a positive TWA test probably is related to abnormal myocardial arrangement (disarray) and/or fibrosis, and it may reflect electrical instability of the myocardium.