Prognostic value of the QTc interval after cardiac transplantation
Prognostic value of the QTc interval after cardiac transplantation
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DOI：
10.1016/j.healun.2005.05.004
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发表时间：
2006-01-01
影响因子：
8.9
通讯作者：
Radovancevic, B
中科院分区：
文献类型：
--
作者：
Vrtovec, B;Radovancevic, R;Radovancevic, B
工作背景：虽然QTc间期延长被认为是非移植人群中不良结局的风险因素，但其在心脏移植受者中的预测价值尚未研究。这项研究是为了确定是否延长QTc间期是一个有用的预测结果，在心脏transplants.Methods：QTc间期测定587例成人患者接受心脏移植1982年5月至2002年1月。QT间期为。通过对标准心电图（ECG）的所有12个导联中的3个连续搏动取平均值并用Bazett公式校正来确定。在移植后7天内获得基线ECG;在常规血管造影时每年记录随访ECG。结果：随访期间，241例患者死亡。这些患者的平均QTc间期与其余队列相当（432 +/- 26 msec vs 423 +/- 25 msec，p = 0.07）。然而，移植后第一年和第二年之间QTc间期相对增加>= 10%的患者（Δ QTc >= 10%）的死亡风险是Δ QTc < 10%的患者的6.86倍（p = 0.0005）。此外，在多变量分析中，Δ QTc >= 10%是长期死亡率的唯一独立预测因子（p = 0.0008）。结论：在移植后第一年和第二年之间，QTc间期相对增加>= 10%是死亡率的一个强有力的独立预测因子。心脏移植患者心肺移植杂志2006;25：29-35.版权所有（c）2006国际心肺移植学会。
Background: Although QTc interval prolongation is considered a risk factor for adverse outcome in the non-transplant population, its predictive value in heart transplant recipients has not been studied yet. This study was conducted to determine whether prolonged QTc interval is a useful predictor of outcome in heart transplant recipients.Methods: QTc intervals were measured in 587 adult patients who underwent heart transplantation between May 1982 and January 2002. QT interval duration was. determined by averaging 3 consecutive beats in all 12 leads of the standard electrocardiogram (ECG) and corrected with the Bazett formula. Baseline ECGs were obtained within 7 days after transplantation; follow-up ECGs were'recorded annually at the time of routine angiography. Patients were followed over 85 t 65 months (range, 3 months-17 years).Results: During follow-up, 241 patients died. The mean QTc interval duration in these patients was comparable with that in the remaining cohort (432 +/- 26 msec vs 423 +/- 25 msec, p = 0.07). However, patients with a relative increase in QTc duration of >= 10% between the first and second post-transplantation year,(Delta QTc >= 10%) had a 6.86-times higher risk of dying compared with patients with Delta QTc < 10% (p = 0.0005). Furthermore, Delta QTc >= 10% was the only independent predictor of long-term mortalityon multivariate analysis (p = 0.0008).Conclusions: A relative increase in QTc interval duration of >= 10% between the first and second post-transplantation year is a strong, independent predictor of mortality in. heart transplant recipients. J Heart Lung Transplant 2006;25:29-35. Copyright (c) 2006 by the International Society for Heart and Lung Transplantation.