Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume
Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume
复制标题
DOI：
10.1093/eurheartj/ehi140
复制
发表时间：
2005-05-01
影响因子：
39.3
通讯作者：
Vliegen, HW
中科院分区：
文献类型：
--
作者：
van Huysduynen, BH;van Straten, A;Vliegen, HW
法乐氏综合征（Fallot）患者在完全纠正后较晚出现QRS波时限较长，易发生严重心律失常和心源性猝死。肺动脉返流是右心室（RV）衰竭和QRS延长的常见原因。我们研究了肺动脉瓣置换术（PVR）对QRS时限和RV volume.Methods和结果26例连续法洛患者术前和术后6-12个月的心脏磁共振（CMR）进行了评价。在这项研究中，我们提出了计算机辅助分析的标准12导联心电图最接近的时间CMR研究。对于整个组，QRS持续时间缩短了6 +/- 8 ms，从151 +/- 30缩短至144 +/- 29 ms（P = 0.002）。26名患者中有18名患者的QRS时限从152 +/- 32 ms减少到142 +/- 31 ms，减少了10 +/- 6 ms。26名患者中有8名患者的QRS时限保持不变或略微增加了3 +/- 3 ms，从148 +/- 27降至151 +/- 25 ms。CMR显示RV舒张末期容积从305 +/- 87降至210 +/- 62 mL（P = 0.000004）。QRS波时限变化与右室舒张末期容积变化相关（r = 0.54，P = 0.01）。QRS波群的减少量与手术的成功有关，如RV舒张末期容积的减少所表示的。
Aims Late after total correction, Fallot patients with a tong QRS duration are prone to serious arrhythmias and sudden cardiac death. Pulmonary regurgitation is a common cause of right ventricular (RV) failure and QRS lengthening. We studied the effects of pulmonary valve replacement (PVR) on QRS duration and RV volume.Methods and results Twenty-six consecutive Fallot patients were evaluated both pre-operativety and 6-12 months post-operatively by cardiac magnetic resonance (CMR). In this study, we present the computer-assisted analysis of the standard 12-lead electrocardiograms closest in time to the CMR studies. For the whole group, QRS duration shortened by 6 +/- 8 ms, from 151 +/- 30 to 144 +/- 29 ms (P = 0.002). QRS duration decreased in 18 of 26 patients by 10 +/- 6 ms, from 152 +/- 32 to 142 +/- 31 ms. QRS duration remained constant or increased slightly in eight of 26 patients by 3 +/- 3 ms, from 148 +/- 27 to 151 +/- 25 ms. CMR showed a decrease in RV end-diastolic volume from 305 +/- 87 to 210 +/- 62 mL (P = 0.000004). QRS duration changes correlated with RV end-diastolic volume changes (r = 0.54, P = 0.01).Conclusion Our study shows that PVR reduces QRS duration. The amount of QRS reduction is related to the success of the operation, as expressed by the reduction in RV end-diastolic volume.