目的:探讨室速患者T波峰末间期(T peak-T end interval,TPe)、T波峰末间期离散度的临床意义。方法:对36例室速患者及40例非室速患者分别测量同步12导联动态心电图的TPe间期,计算出TPe离散度(最长TPe与最短TPe之差)及其心率校正值。结果...目的:探讨室速患者T波峰末间期(T peak-T end interval,TPe)、T波峰末间期离散度的临床意义。方法:对36例室速患者及40例非室速患者分别测量同步12导联动态心电图的TPe间期,计算出TPe离散度(最长TPe与最短TPe之差)及其心率校正值。结果:室速组的TPe/RR、TPe离散度/RR较非室速组明显延长(P<0.01)。结论:室速患者TPe间期、TPe离散度延长有显著统计学意义。提示TPe间期、TPe离散度延长与室速的发生有密切关系。展开更多
Interactions between the functioning of the heart and the liver have been described, with heart diseases affecting the liver, liver diseases affecting the heart, and conditions that simultaneously affect both. The hea...Interactions between the functioning of the heart and the liver have been described, with heart diseases affecting the liver, liver diseases affecting the heart, and conditions that simultaneously affect both. The heart is one of the most adversely affected organs in patients with liver cirrhosis. For example, arrhythmias and electrocardiographic changes are observed in patients with liver cirrhosis. The risk for arrhythmia is influenced by factors such as cirrhotic cardiomyopathy, cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions.展开更多
Objective:Many studies have shown that blood glucose fluctuations(GFs)are more harmful to patients with diabetes mellitus(DM)than sustained hyperglycemia.However,the effect of GF on electrocardiogram(ECG)parameters an...Objective:Many studies have shown that blood glucose fluctuations(GFs)are more harmful to patients with diabetes mellitus(DM)than sustained hyperglycemia.However,the effect of GF on electrocardiogram(ECG)parameters and vulnerability to ventricular tachycardia/fibrillation(VT/VF)remains poorly characterized.This study aimed to assess the effect of GF on ECG parameters and induction of VT/VF in streptozotocin(STZ)-induced diabetic Sprague-Dawley rats.Methods:Male Sprague-Dawley rats were injected with STZ and randomly divided into 3 treatment groups:controlled STZ-induced diabetic rats(C-STZ)(n=10);uncontrolled STZ-induced diabetic rats(U-STZ)(n=10);and STZ-induced diabetic rats with glucose fluctuations(GF-STZ)(n=10).After 12 weeks,baseline ECG recordings were taken and a VT/VF test was performed with the administration of caffeine and dobutamine.Hematoxylin&eosin and masson staining were used to evaluate pathological cardiac changes after intervention.Results:No significant difference in heart rate,RR interval,P wave(duration and height),PR segment,PR interval,QRS wave duration,and T wave height was observed among the 3 groups(P>0.05).Compared with the C-STZ group,the U-STZ and GF-STZ groups both had a longer T wave duration((62.41±2.38)ms vs.(78.37±4.64)ms and(96.06±4.60)ms,P<0.05),QT interval((83.66±2.31)ms vs.(101.75±4.56)ms and(119.14±4.88)ms,P<0.05),and QTc interval((77.45±1.36)ms vs.(91.36±3.49)ms and(104.55±3.01)ms,P<0.05),all of which were longest in the GF-STZ group(P<0.05).Additionally,the GF-STZ group had the highest VT/VF occurrence and duration and the highest arrhythmia score.Conclusion:This study revealed GF can significantly prolong the QT interval,QTc interval,and T wave duration,as well as increase vulnerability to VT/VF in rats,which may be an important electrophysiological mechanism of GF-related ventricular arrhythmia.展开更多
文摘目的:探讨室速患者T波峰末间期(T peak-T end interval,TPe)、T波峰末间期离散度的临床意义。方法:对36例室速患者及40例非室速患者分别测量同步12导联动态心电图的TPe间期,计算出TPe离散度(最长TPe与最短TPe之差)及其心率校正值。结果:室速组的TPe/RR、TPe离散度/RR较非室速组明显延长(P<0.01)。结论:室速患者TPe间期、TPe离散度延长有显著统计学意义。提示TPe间期、TPe离散度延长与室速的发生有密切关系。
文摘Interactions between the functioning of the heart and the liver have been described, with heart diseases affecting the liver, liver diseases affecting the heart, and conditions that simultaneously affect both. The heart is one of the most adversely affected organs in patients with liver cirrhosis. For example, arrhythmias and electrocardiographic changes are observed in patients with liver cirrhosis. The risk for arrhythmia is influenced by factors such as cirrhotic cardiomyopathy, cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions.
基金the Natural Science Foundation of China(81770331)the Wuxi Health Commission for the Youth Research Foundation(Q202034).
文摘Objective:Many studies have shown that blood glucose fluctuations(GFs)are more harmful to patients with diabetes mellitus(DM)than sustained hyperglycemia.However,the effect of GF on electrocardiogram(ECG)parameters and vulnerability to ventricular tachycardia/fibrillation(VT/VF)remains poorly characterized.This study aimed to assess the effect of GF on ECG parameters and induction of VT/VF in streptozotocin(STZ)-induced diabetic Sprague-Dawley rats.Methods:Male Sprague-Dawley rats were injected with STZ and randomly divided into 3 treatment groups:controlled STZ-induced diabetic rats(C-STZ)(n=10);uncontrolled STZ-induced diabetic rats(U-STZ)(n=10);and STZ-induced diabetic rats with glucose fluctuations(GF-STZ)(n=10).After 12 weeks,baseline ECG recordings were taken and a VT/VF test was performed with the administration of caffeine and dobutamine.Hematoxylin&eosin and masson staining were used to evaluate pathological cardiac changes after intervention.Results:No significant difference in heart rate,RR interval,P wave(duration and height),PR segment,PR interval,QRS wave duration,and T wave height was observed among the 3 groups(P>0.05).Compared with the C-STZ group,the U-STZ and GF-STZ groups both had a longer T wave duration((62.41±2.38)ms vs.(78.37±4.64)ms and(96.06±4.60)ms,P<0.05),QT interval((83.66±2.31)ms vs.(101.75±4.56)ms and(119.14±4.88)ms,P<0.05),and QTc interval((77.45±1.36)ms vs.(91.36±3.49)ms and(104.55±3.01)ms,P<0.05),all of which were longest in the GF-STZ group(P<0.05).Additionally,the GF-STZ group had the highest VT/VF occurrence and duration and the highest arrhythmia score.Conclusion:This study revealed GF can significantly prolong the QT interval,QTc interval,and T wave duration,as well as increase vulnerability to VT/VF in rats,which may be an important electrophysiological mechanism of GF-related ventricular arrhythmia.
