Clinical significance of detecting transmural dispersion of repolarization in patients with hypertrophic cardiomyopathy / 中国医师进修杂志

ABSTRACT

Objective To explore the changes and clinical significance of transmural dispersion of repolarization (TDR) in patients with hypertrophic cardiomyopathy (HCM). Methods Seventy-two patients with HCM (observation group) and 72 healthy subjects (control group) in Shengjing Hospital of China Medical University were selected from January 2015 to October 2017. The 12-lead conventional electrocardiogram was performed on enrolled personnel in 2 groups to measure T-peak T-end (TpTe), correct the QT interval (QTc), QT interval dispersion (QTd) and TpTe/QTc. The observation group underwent 24 h dynamic electrocardiography. The patients were divided into ventricular arrhythmia subgroup and non- ventricular arrhythmia subgroup according to the results of 24 h dynamic electrocardiography, and the TpTe, QTc, QTd and TpTe/QTc were compared. Results The TpTe, QTc, QTd and TpTe/QTc in observation groups were significantly higher than those in control group(112.5 ± 11.2) ms vs. (105.6 ± 9.2) ms, (396.5 ± 13.5) ms vs. (385.3 ± 12.5) ms, (36.5 ± 6.4) ms vs. (32.4 ± 5.4) ms and 0.289 ± 0.016 vs. 0.262 ± 0.015, and there were statistical differences (P＜0.05). In observation group, the 24 h dynamic electrocardiogram result showed that 47 patients had ventricular arrhythmia (ventricular arrhythmia subgroup) and 25 patients had not ventricular arrhythmia (non-ventricular arrhythmia subgroup). The TpTe, QTc, QTd and TpTe/QTc in ventricular arrhythmia subgroup were significantly higher than those in non-ventricular arrhythmia subgroup (114.4 ± 14.5) ms vs. (110.3 ± 12.2) ms, (402.5 ± 15.2) ms vs. (392.0 ± 12.1) ms, (37.5 ± 6.2) ms vs. (35.4 ± 6.5) ms and 0.292 ± 0.016 vs. 0.285 ± 0.015, and there were statistical differences (P＜0.05). Conclusions The values of TpTe, QTc, QTd and TpTe/QTc reflect the increase of transmural dispersion of repolarization in patients with HCM, and have a certain predictive effect on ventricular arrhythmia.