Exercise‐Related QT Interval Shortening with a Peaked T Wave in a Healthy Boy with a Family History of Sudden Cardiac Death
Exercise‐Related QT Interval Shortening with a Peaked T Wave in a Healthy Boy with a Family History of Sudden Cardiac Death
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有心脏性猝死家族史的健康男孩与运动相关的 QT 间期缩短并伴有 T 波峰值
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发表时间：
2012
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通讯作者：
Y. Aizawa
中科院分区：
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作者：
M. Chinushi;A. Sato;K. Iijima;Katuya Suzuki;Furushima Hiroshi;D. Izumi;Hiroshi Watanabe;Hasegawa Kanae;Y. Aizawa
一个无症状的15岁男孩，有心脏性猝死家族史，被转介进行心脏疾病筛查。静息时12导联心电图显示QT/QTc(Bazett)/QTc（Fredericia）间期较短，为320/388/364 ms，但在跑步机试验后，QT/QTc（Fredericia）间期进一步缩短至200/339/284 ms，并出现峰值T波。其他常规心脏检查正常，但双心室有效不应期均小于180 ms，双心室外刺激可重复诱导非持续性多形性室性心动过速。静脉给药肾上腺素也可引起QT间期缩短和T波峰值，起搏后第一次心跳T波出现驼峰，前R-R间期较长。此外，几个过早的心室复合体起源于与驼峰相似的时间。遗传分析未发现KCNQ1、KCNH2、KCNE1、KCNE2、KCNJ2、SCN5A基因突变，但发现SCN5A基因单核苷酸多态性（C5457T）。
An asymptomatic 15‐year‐old boy, who had a family history of sudden cardiac death, was referred for screening for cardiac disease. The 12‐lead electrocardiogram at rest showed a short QT/QTc(Bazett)/QTc(Fredericia) interval of 320/388/364 ms, but the intervals were further shortened to 200/339/284 ms after the treadmill test concomitant with appearance of a peaked T wave. Other conventional cardiac examinations were normal, but effective refractory period was less than 180 ms in both ventricles, and double ventricular extrastimulation reproducibly induced nonsustained polymorphic ventricular tachycardia. Intravenous administration of epinephrine also induced a short QT interval and a peaked T wave, and a hump was manifested on the T wave of the first postpacing beat with a longer preceding R–R interval. Furthermore, a couple of premature ventricular complexes originated from a similar timing as the hump. Genetic analysis did not show the mutation in KCNQ1, KCNH2, KCNE1, KCNE2, KCNJ2, SCN5A genes but revealed single nucleotide polymorphism (C5457T) in SCN5A gene.