Percutaneous coronary rotational atherectomyにおける胸部誘導QT dispersion
Percutaneous coronary rotational atherectomy (PTCRA) におけるQT dispersion (QTd) の測定意義について検討した.主要冠動脈に75%以上の狭窄病変を有しPTCRAを行った30例 (男性24例, 女性6例, 平均年齢64±10歳) を対象とした.標準12誘導心電図胸部誘導を用い, QT間隔からQTd (最大QT-最小QT) を計測し, PTCRA前, 直後, 24時間後, および慢性期造影時で比較検討した.QTdはbaselineとの比較において, PTCRA直後 (p<O.05) , 24時間後 (p<0.01)...
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| Published in | 心電図 Vol. 21; no. 1; pp. 46 - 52 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本不整脈心電学会
2001
日本心電学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1660 1884-2437 |
| DOI | 10.5105/jse.21.46 |
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| Abstract | Percutaneous coronary rotational atherectomy (PTCRA) におけるQT dispersion (QTd) の測定意義について検討した.主要冠動脈に75%以上の狭窄病変を有しPTCRAを行った30例 (男性24例, 女性6例, 平均年齢64±10歳) を対象とした.標準12誘導心電図胸部誘導を用い, QT間隔からQTd (最大QT-最小QT) を計測し, PTCRA前, 直後, 24時間後, および慢性期造影時で比較検討した.QTdはbaselineとの比較において, PTCRA直後 (p<O.05) , 24時間後 (p<0.01) とも有意な短縮が認められた.また, 基礎心疾患による比較では, これらの変化は心筋梗塞のない狭心症群で顕著であった.慢性期造影において, 標的血管の再狭窄の有無から2群間に分類し比較した場合, QTdは再狭窄群で有意に増大していた (p<0.05) .PTCRAにおけるQTdは, 冠動脈病変の改善に伴い有意に減少した.また, 慢性期のQTdの変化は, PTCRA後の再狭窄の指標となり得ることが示唆された. |
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| AbstractList | Percutaneous coronary rotational atherectomy (PTCRA) におけるQT dispersion (QTd) の測定意義について検討した.主要冠動脈に75%以上の狭窄病変を有しPTCRAを行った30例 (男性24例, 女性6例, 平均年齢64±10歳) を対象とした.標準12誘導心電図胸部誘導を用い, QT間隔からQTd (最大QT-最小QT) を計測し, PTCRA前, 直後, 24時間後, および慢性期造影時で比較検討した.QTdはbaselineとの比較において, PTCRA直後 (p<O.05) , 24時間後 (p<0.01) とも有意な短縮が認められた.また, 基礎心疾患による比較では, これらの変化は心筋梗塞のない狭心症群で顕著であった.慢性期造影において, 標的血管の再狭窄の有無から2群間に分類し比較した場合, QTdは再狭窄群で有意に増大していた (p<0.05) .PTCRAにおけるQTdは, 冠動脈病変の改善に伴い有意に減少した.また, 慢性期のQTdの変化は, PTCRA後の再狭窄の指標となり得ることが示唆された. Percutaneous coronary rotational atherectomy(PTCRA)におけるQT dispersion(QTd)の測定意義について検討した. 主要冠動脈に75％以上の狭窄病変を有しPTCRAを行った30例(男性24例, 女性6例, 平均年齢64±10歳)を対象とした. 標準12誘導心電図胸部誘導を用い, QT間隔からQTd(最大QT-最小QT)を計測し, PTCRA前, 直後, 24時間後, および慢性期造影時で比較検討した. QTdはbaselineとの比較において, PTCRA直後(p＜0.05), 24時間後(p＜0.01)とも有意な短縮が認められた. また, 基礎心疾患による比較では, これらの変化は心筋梗塞のない狭心症群で顕著であった. 慢性期造影において, 標的血管の再狭窄の有無から2群間に分類し比較した場合, QTdは再狭窄群で有意に増大していた(p＜0.05). PTCRAにおけるQTdは, 冠動脈病変の改善に伴い有意に減少した. また, 慢性期のQTdの変化は, PTCRA後の再狭窄の指標となり得ることが示唆された. (心電図 21：No.1, 46～52, 2001) |
| Author | 八木, 博 松岡, 博昭 浅川, 洋 堀中, 繁夫 渡辺, 滋子 矢部, 彰久 土谷, 範昭 原, 和義 高野, 幸一 原, すおみ 東, 晃生 |
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| References | 12) Pye M, Quinn AC, Cobbe SM: QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Br Heart J 71: 511, 1994 22) Puljevic D, Smalcelj A, Durakovic Z, Goldner V Effects of postmyocardial infarction scar size, cardiac function, and severity of coronary artery disease on QT interval dispersion as a risk factor for complex ventricular arrhythmia. Pacing Clin Electrophysiol 21: 1508, 1998 8) Bottner RK, Hardigan KR: High-speed rotational ablation for in-stent restenosis. Cathet Cardiovasc Diagn 40: 144, 1997 19) Musha H, So T, Hashimoto N, Eto F, Ozawa A, Kunishima T, Murayama M: Dynamic changes of QT dispersion as a predictor of myocardial ischemia on exercise testing in patients with angina pectoris. Jpn Heart J 40: 119, 1999 20) 丹波裕子, 犀川哲典, 前田利裕, 吉村彰, 竹下泰, 高倉健, 米持英俊, 坂田利家, 伊東盛夫: 健常成人におけるQTdispersionの検討. 心電図15: 1, 1995 11) Cowan JC, Yusoff K, Moore M, Amos PA, Gold AE, Bourke JP, Tansuphaswadikul S, Campbell RW Importance of lead selection in QT interval measurement. Am J Cardiol 61: 83, 1998 18) Yoshimura M, Matsumoto K, Watanabe M, Yamashita N, Sanuki E, Sumida Y: Significance of exercise QT dispersion in patients with coronary artery disease who do not have exercise-induced ischemic ST-segment changes. Jpn Circ J 63: 517, 1999 13) Barr CS, Nass A, Freeman M, Lang CC, Struthers AD: QT dispersion and sudden unexpected death in chronic heart failure. Lancet 343: 327, 1994 10) Lepeschkin E, Surawicz B: The measurement of the QT interval of the electrocardiogram. Circulation 6 378, 1952 15) Dilaveris P, Andrikopuolos G, Metaxas G, Richter D, Avgeropoulou C, Androulakis A, Gialafos E, Michaelides A, Toutouzas P, Gialafos J: Effects of ischemia on QT dispersion during spontaneous anginal episodes. J Electrocardiol 32: 199, 1999 14) Anastasiou-Napa MI, Nanas JN, Karagounis LA, Tsagalou EP, Alexopoulos GE, Toumanidis S, Gerali S, Stamatelopoulos SF, Moulopoulos SD: Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality. Am J Cardiol 85: 1212, 2000 23) Schneider CA, Voth E, Baer FM, Horst M, Wagner R, Sechtem U: QT dispersion is determined by the extent of viable myocardium in patients with chronic Q-wave myocardial infarction. Circulation 96: 3913, 1997 2) Kelly RF, Parillo JE, Hollenberg SM: Effect of coronary angioplasty on QT dispersion. Am Heart J 134: 399, 1997 16) 高松剛, 嶋田佳文, 多々見良三, 石瀬昌三: 安定期の冠攣縮性狭心症におけるQT時間およびQTdispersionについての検討. 心電図20: 299, 2000 3) Tarabey R, Sukenik D, Molnar J, Somberg JC: Effect of intracoronary balloon inflation at percutaneous transluminal coronary angioplasty on QT dispersion. Am Heart J 135: 519, 1998 6) MacIsaac AT, Bass TA, Buchbinder M, Cowley MJ, Leon MB, Warth DC, Whitlow PL: High speed rotational atherectomy: outcome in calcified and noncalcified coronary artery lesions. J Am Coll Cardiol 26: 731, 1995 1) Yunus A, Gillis AM, Traboulsi M, Duff HJ, Wyse DG, Knudtson ML, Mitchell LB: Effect of coronary angioplasty on precordial QT dispersion. Am J Cardiol 79: 1339, 1997 21) Goldeli O, Kirimli O, Asian O, Badak O, Guneri S Value of QT dispersion in diagnosis of restenosis after ntracoronary stent implantation. Int J Cardiol 72: 13, 1999 9) Dauerman HL, Baim DS, Cutlip DE, Sparano AM, Gibson CM, Kuntz RE, Carrozza JP, Garber GR, Cohen DJ: Mechanical debulking versus balloon angioplasty for the treatment of diffuse in-stent restenosis. Am J Cardiol 82: 277, 1998 5) Warth DC, Leon MB, O'Neill W, Zacca N, Polissar NL, Buchbinder M: Rotational atherectomy multicenter registry: acute results, complications and 6-month angiographic follow-up in 709 patients. J Am Coll Cardiol 24: 641, 1994 17) Shah CP, Thakur RK, Reisdorff EJ, Lane E, Aufderheide TP, Hayes OW: QT dispersion may be a useful adjunct for detection of myocardial infarction in the chest pain center. Am Heart J 136: 496, 1998 4) Dorros G, Iyer S, Zaitoun R, Lewin R, Cooley R, Olson K: Acute angiographic and clinical outcome of high speed percutaneous rotational atherectomy (Rotablator) . Cathet Cardiovasc Diagn 22: 157, 1991 7) Abbo KM, Dooris M, Glazier S, O'Neill WW, Byrd D, Grines CL, Safian RD: Features and outcome of noreflow after percutaneous coronary intervention. Am J Cardiol 75: 778, 1995 |
| References_xml | – reference: 3) Tarabey R, Sukenik D, Molnar J, Somberg JC: Effect of intracoronary balloon inflation at percutaneous transluminal coronary angioplasty on QT dispersion. Am Heart J 135: 519, 1998 – reference: 7) Abbo KM, Dooris M, Glazier S, O'Neill WW, Byrd D, Grines CL, Safian RD: Features and outcome of noreflow after percutaneous coronary intervention. Am J Cardiol 75: 778, 1995 – reference: 16) 高松剛, 嶋田佳文, 多々見良三, 石瀬昌三: 安定期の冠攣縮性狭心症におけるQT時間およびQTdispersionについての検討. 心電図20: 299, 2000 – reference: 4) Dorros G, Iyer S, Zaitoun R, Lewin R, Cooley R, Olson K: Acute angiographic and clinical outcome of high speed percutaneous rotational atherectomy (Rotablator) . Cathet Cardiovasc Diagn 22: 157, 1991 – reference: 17) Shah CP, Thakur RK, Reisdorff EJ, Lane E, Aufderheide TP, Hayes OW: QT dispersion may be a useful adjunct for detection of myocardial infarction in the chest pain center. Am Heart J 136: 496, 1998 – reference: 1) Yunus A, Gillis AM, Traboulsi M, Duff HJ, Wyse DG, Knudtson ML, Mitchell LB: Effect of coronary angioplasty on precordial QT dispersion. Am J Cardiol 79: 1339, 1997 – reference: 2) Kelly RF, Parillo JE, Hollenberg SM: Effect of coronary angioplasty on QT dispersion. Am Heart J 134: 399, 1997 – reference: 14) Anastasiou-Napa MI, Nanas JN, Karagounis LA, Tsagalou EP, Alexopoulos GE, Toumanidis S, Gerali S, Stamatelopoulos SF, Moulopoulos SD: Relation of dispersion of QRS and QT in patients with advanced congestive heart failure to cardiac and sudden death mortality. Am J Cardiol 85: 1212, 2000 – reference: 23) Schneider CA, Voth E, Baer FM, Horst M, Wagner R, Sechtem U: QT dispersion is determined by the extent of viable myocardium in patients with chronic Q-wave myocardial infarction. Circulation 96: 3913, 1997 – reference: 22) Puljevic D, Smalcelj A, Durakovic Z, Goldner V Effects of postmyocardial infarction scar size, cardiac function, and severity of coronary artery disease on QT interval dispersion as a risk factor for complex ventricular arrhythmia. Pacing Clin Electrophysiol 21: 1508, 1998 – reference: 5) Warth DC, Leon MB, O'Neill W, Zacca N, Polissar NL, Buchbinder M: Rotational atherectomy multicenter registry: acute results, complications and 6-month angiographic follow-up in 709 patients. J Am Coll Cardiol 24: 641, 1994 – reference: 12) Pye M, Quinn AC, Cobbe SM: QT interval dispersion: a non-invasive marker of susceptibility to arrhythmia in patients with sustained ventricular arrhythmias? Br Heart J 71: 511, 1994 – reference: 19) Musha H, So T, Hashimoto N, Eto F, Ozawa A, Kunishima T, Murayama M: Dynamic changes of QT dispersion as a predictor of myocardial ischemia on exercise testing in patients with angina pectoris. Jpn Heart J 40: 119, 1999 – reference: 8) Bottner RK, Hardigan KR: High-speed rotational ablation for in-stent restenosis. Cathet Cardiovasc Diagn 40: 144, 1997 – reference: 13) Barr CS, Nass A, Freeman M, Lang CC, Struthers AD: QT dispersion and sudden unexpected death in chronic heart failure. Lancet 343: 327, 1994 – reference: 15) Dilaveris P, Andrikopuolos G, Metaxas G, Richter D, Avgeropoulou C, Androulakis A, Gialafos E, Michaelides A, Toutouzas P, Gialafos J: Effects of ischemia on QT dispersion during spontaneous anginal episodes. J Electrocardiol 32: 199, 1999 – reference: 6) MacIsaac AT, Bass TA, Buchbinder M, Cowley MJ, Leon MB, Warth DC, Whitlow PL: High speed rotational atherectomy: outcome in calcified and noncalcified coronary artery lesions. J Am Coll Cardiol 26: 731, 1995 – reference: 10) Lepeschkin E, Surawicz B: The measurement of the QT interval of the electrocardiogram. Circulation 6 378, 1952 – reference: 18) Yoshimura M, Matsumoto K, Watanabe M, Yamashita N, Sanuki E, Sumida Y: Significance of exercise QT dispersion in patients with coronary artery disease who do not have exercise-induced ischemic ST-segment changes. Jpn Circ J 63: 517, 1999 – reference: 20) 丹波裕子, 犀川哲典, 前田利裕, 吉村彰, 竹下泰, 高倉健, 米持英俊, 坂田利家, 伊東盛夫: 健常成人におけるQTdispersionの検討. 心電図15: 1, 1995 – reference: 21) Goldeli O, Kirimli O, Asian O, Badak O, Guneri S Value of QT dispersion in diagnosis of restenosis after ntracoronary stent implantation. Int J Cardiol 72: 13, 1999 – reference: 9) Dauerman HL, Baim DS, Cutlip DE, Sparano AM, Gibson CM, Kuntz RE, Carrozza JP, Garber GR, Cohen DJ: Mechanical debulking versus balloon angioplasty for the treatment of diffuse in-stent restenosis. Am J Cardiol 82: 277, 1998 – reference: 11) Cowan JC, Yusoff K, Moore M, Amos PA, Gold AE, Bourke JP, Tansuphaswadikul S, Campbell RW Importance of lead selection in QT interval measurement. Am J Cardiol 61: 83, 1998 |
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| Snippet | Percutaneous coronary rotational atherectomy (PTCRA) におけるQT dispersion (QTd) の測定意義について検討した.主要冠動脈に75%以上の狭窄病変を有しPTCRAを行った30... Percutaneous coronary rotational atherectomy(PTCRA)におけるQT dispersion(QTd)の測定意義について検討した. 主要冠動脈に75％以上の狭窄病変を有しPTCRAを行った30例(... |
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| SubjectTerms | アテレクトミー 経皮的冠動脈形成術 虚血性心疾患 |
| Title | Percutaneous coronary rotational atherectomyにおける胸部誘導QT dispersion |
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