运动诱发心肌缺血对QT间期—心率依从性的影响  

Effect of the exercise induced ischemia on QT rate-dependence

作　　者：刘霞[1] 张娟赢[1] 陈菊芳[1] 

机构地区：[1]上海第二医科大学附属瑞金医院心脏科,200025

出　　处：《临床心电学杂志》2002年第1期3-6,共4页Journal of Clinical Electrocardiology

摘　　要：目的　观察运动诱发心肌缺血时QT间期与心率之间的相关性。方法　运动终点和运动终止后均有ST段下移 ,各时段中 12导联T波均清晰者入选 ,共 44例 ,其中男 30例 ,女 14例 ,平均年龄5 3± 8岁 (4 2 - 71)。结果　 1 运动终止时和运动终止后各时段的QT间期显著短于运动前。 2 运动前后各时段 ,QT间期和心率均有良好相关性。 3 运动终点和运动终止后 1分时 ,直线回归和曲线回归均与运动前有显著性差异 ,由回归方程求出的心率在 6 0次 /分时的QT间期与QTc值不同。 4 在运动终点时 ,QT间期与心率和ST段下移值之间的多元回归分析 ,仅心率有独立的预测价值。结论　在运动诱发心肌缺血的状态下 ,QT间期尽管仍与心率呈线性关系 ,但随心率的增加 ,QT间期缩短减少。Objective The aim of this study was to observe the corelation between the QT interval and heart rate during the exercise-induced ischemia.Methods 44cases with ST segment depression at the peak of exercise and sustained to the recovery phase of exercise test were selected.In all of these cases,the T Wave was clear in 12 leads and also in each epoch.Results1.At the peak of exercise and in the recovery phase of exercise test,the QT interval in each epoch was significantly shorter than that before exercise.2.Both before exercise and after exercise,there was a corelation between QT interval and heart rate.3.At the peak of exercise and the first minute in the recovery phase of exercise test,the liner regression line and the logarithmic regression line were different from those lines before exercise.The QT interval at 60 bpm predictive by the regression equation was different from QTc.4.At the peak of exercise,multiple regression showed that only heart rate had independent predictive value(P<0.001).Conclusion These results suggest that during the exercise-induced ischemia,although the QT interval has corelation to heart rate,but along with heart rate increase,the shortening of QT interval is less.The relationship between QTinterval and heart rate is quite complicated.

关 键 词：心肌缺血 QT间期 心电图 运动诱发 心率依从性 

分 类 号：R540.41[医药卫生—心血管疾病] R542.2[医药卫生—内科学]