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قياس وتفسير وامكانية الاستخدام السريري لتشتت فترات QT والمعلمات لتخطيط صدى القلب في مرضى مرض القلب الاقفاري == Measurement, Interpretation, And Use Of Clinical Potential Of QT Dispersion And Intervals With Echocardiographic Parameters In Patients With Ischemic Heart Disease
Author name:
فراس عبد الودود عبد العزيز
Supervisor name:
تقي علي موسى الموسوي الواجدي | بسام طالب فائق الكيلاني
General topic:
Medicine
Specific topic:
Medical Physics
Degree:
Doctorate
University:
Mustansiriyah University
Language:
English
University location:
Baghdad
First pages:
19T1162 - p.pdf
Abstract:
اجري تخطيط القلب الكهربائي واخذت نتائج فحص الايكو لاربعة وخمسون مريض (اناث وذكور)، عمرهم المتوسط كان 51,1 ± 6,7 سنة؛ المدى كان يتراوح بين 35 - 66 سنة. المرضى الذي جندوا في الدراسة الحالية صنفوا الى اربع مجموعات : مرضى القلب الاقفاري الشرايين التاجية لوحده | ECG traces were recorded and echo findings were obtained for 54 patient (females were 15 and males were 39), their mean age was 51.1 ± 6.7 years; the range was 35 - 66 years. Patients that were recruited in the present study were classified into four groups : Patients with Ischemic Heart Disease (IHD) alone were labeled as group 1, Patients with IHD and Hypertension (HT) were labeled as group 2, Patients with IHD and diabetes mellitus (DM) were labeled as group 3, and Patients with IHD, HT, and DM were labeled as group 4. Fourteen age - matched apparently healthy subjects (mean age 48.6 ± 4.0 years) were chosen for comparison with group 1 patients. Patients' ECGs didn't show clear IHD before Treadmill test. Patients who showed clear ischemic changes within the treadmill test or during the rest time after completion of the treadmill test were sent to echo unit for structural / functional assessment of their hearts. Before stress test, simultaneous resting 12 lead ECG, arterial blood pressure, heart rate, height and weight of the patients were measured, age were recorded, smoking habit, and history of any cardiovascular disease. QT (The time interval measured from Q - wave onset the end of the T - wave), QT peak (The time interval measured from the Q - wave onset to the peak of the T - wave), TpTe (The time interval measured from the peak to the end of the T - wave)intervals were measured manually by tangent method on resting ECG. The dispersion of QT, QTp, TpTe intervals determined by the difference between minimal and maximal of these above measured intervals within 12 leads. The measured QT intervals were corrected for the subject's heart rate by using the standard Bazett's formula. In comparison with healthy subjects, QT dispersion (QTd) and QT peak dispersion (QTpd) of patients in group 1 were significantly higher (by 29% and 25% respectively) relative to their counterpart dispersion of healthy subjects, Tpeak - Tend dispersion (TpTed) of patients in group 1 was significant lower by 57% than TpTed of healthy subjects, QT interval and QTp interval of patients in group 1 was significantly longer (by 5% and 18% respectively) relative to their counterpart intervals of healthy subjects, in contrast, TpTe interval of patients in group 1 was significantly lower (by 27%) relative to their counterpart in healthy subjects. QT - intervals of patients in group 2, 3, and 4 are significantly higher (by 2%,4%, 3%) respectively than patients in group 1. QTp interval of group 3 was significantly higher than group 1, 2, and 4 by (4%, 6%, 4% respectively). No significant differences were observed in QTp interval among group 1, 2, and 4. TpTe interval of group 2, group 3, and group 4 patients were significantly longer by (16%, 6%, 14%) respectively relative to the TpTe interval in patients of group 1. QTd of patients in group 4 is significantly higher by (30%) than QTd of patients in group 1. QTp dispersion of group 4 is significantly higher by (26%) relative to QTp dispersion of group 1. TpTed of group 2 and group 4 were significantly higher (62% and 46% respectively) than TpTed of patients in group 1. LVMI of patients in group 2 and 4 were significantly higher (by 38% and 51% respectively) over the LVMI in patients of group 1. RWT of patients in group 2 and 4 were significantly higher (by 13% and 17% respectively) over the RWT of patients in group 1. PWT of patients in group 2, 3, and 4 was significantly higher (by 15%, 18%, and 21% respectively) over their PWT counterpart of patients in group 1. IVSTS was found to be significantly higher by (19% and 20%) of patients in group 2 and 4 respectively relative to patients in group 1. IVSTD was significantly higher by 24% in patients of group 4 only relative to the IVSTD of patients in group 1. IVSTS and IVSTD were significantly correlated with the QTd and QTpd in group 1. In group 2 patients RWT and PWT were significantly correlated with QTd and QTpd and IVSTD was significantly correlated with QT, QTp, and TpTe interval. In group 3 patients, IVSTD, ARD, and BMI were found to be significantly correlated with QTd and QTpd. significant correlation also was found in this group between RWT and QTp interval and IVSTS was correlated significantly with the QT and QTp intervals in group 4 patients.
