Autori: Corlan AD, Macfarlane PW, De Ambroggi L.

Editorial: Med Biol Eng Comput, 41(5), p.536-542, 2003.

Rezumat:

Diferente legate de sex in stabilitatea distributiei potentialelor ECG pe suprafata corpului in timpul repolarizarii ventriculare.

La femei, situatiile asociate cu prelungirea intervalului QT sunt insotite de un risc mai mare de aparitie a aritmiilor ventriculare maligne cum este torsada varfurilor.
Obiectivul acestui studiu a fost evaluarea diferentelor legate de sex in repolarizarea ventriculara, folosind transformari ale semnalelor electrocardiografice care sunt independente de proprietatile electrice ale toracelui. Am studiat 1410 inregistrari la normali din baza de date `Glasgow’ cu electrocardiograme standard si 52 de harti ECG computerizate de suprafata la normali, inregistrate separat la Milano. Media diferentelor intre 1 si coeficientul corelatie dintre distributia potentialelor pe suprafata corpului la varful undei T si cea de la fiecare esantion pe parcursul undei T este numita indicele de deviatie precoce a repolarizarii (ERDI) pentru intervalul J-Tpeak (intre punctul J si varful unei T) si indicele de deviatie tardiva a repolarizarii (LRDI) pentru intervalul Tpeak-Tend (panta descendenta a undei T). La inregistrarile ECG standard, ERDI a fost 0.42 +/- 0.22 la femei si 0.19 +/- 0.16 la barbati (p<0.000001). LRDI a fost mai mare la barbati sub 50 de ani. La lotul cu harti ECG computerizate de suprafata, ERDI a fost 0.32 +/- 0.21 la femei fata de 0.16 +/- 0.17 la barbati (p<0.01) iar LRDI a fost nesemnificativ mai mare la barbati. Repolarizarea ventriculara prezinta diferente intre sexe chiar folosind o metoda care face abstractie de proprietatile electrice ale toracelui (care, desigur, difera sistematic intre barbati si femei). Women have a higher risk of developing torsade de pointes under OT-prolonging conditions. The electrophysiological differences between the sexes that could account for this are largely unknown. The objective of the work was to evaluate gender differences in repolarisation potentials using a method that is independent of the specific electrical properties of the thorax. 1410 normal recordings from the Glasgow 12-lead ECG database and 52 normal ECG maps obtained separately in Milan were analysed. The average difference between 1 and the correlation coefficient of the instantaneous pattern at the peak of T with that at every other instant is called the early repolarisation deviation index (ERDI) for J-T peak and the late repolarisation deviation index (LRDI) for T peak-T end. In standard ECG recordings, the ERDI was 0.42 +/- 0.22 in females compared with 0.19 +/- 0.16 in males (p < 10(-6)). The LRDI was higher in males under the age of 50. In body surface maps, the ERDI was 0.32 +/- 0.21 in females against 0.16 +/- 0.17 in males (p < 0.01), and the LRDI was non-significantly higher in males. The pattern of instantaneous body surface potentials showed gender differences during repolarisation with a method that is independent of the electrical properties of the thorax.

Cuvinte cheie: repolarizare ventriculara, harti ECG computerizate de suprafata, sex // repolarization, body surface ECG maps, gender

URL: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14572003&dopt=Abstract