【原】吸烟习惯对健康人群的心脏电生理平衡指数的影响

罂粟花anesthGH 2021-07-21

展开全文

本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见

吸烟习惯对健康人群的心脏电生理平衡指数的影响

翻译：唐剑编辑：冯玉蓉审校：曹莹

背景：慢性吸烟被认为是心律失常发生的危险因素。心脏电生理平衡指数(ICEB)是一种较新的反映心室除极与复极平衡的心电图参数，比其他经典的心电图参数如QT间期和校正QT间期(QTc)更能反映室性心律失常(VA)的发生。本研究旨在评估健康习惯性吸烟者的iCEB情况。

方法：2019年1-9月共纳入80例有吸烟习惯的健康受试者(女性占45%，平均年龄39.4 ± 8.1 )和82例健康非吸烟者(女性占40%，平均年龄37.0 ± 8.6 )。从病历中获得人口统计学、临床和心电图特征。将相应的QT间期和QTc间期除以QRS间期，计算iCEB和校正iCEB值。

结果：吸烟组与非吸烟组比较，PR、QRS和QT间期无明显差异，但吸烟组的平均心率和QTc间期明显大于非吸烟组[分别为(427.05 ± 8.90 /min vs 77.8 ± 12.4 bpm，p = 0.016)和(399.9 ± 22.6 msec vs 399.9 ± 12.8 msec，p < 0.001)]。吸烟习惯者的iCEBc明显高于对照组(5.10 ± 0.49 vs 4.68 ± 0.39，p < 0.001)。而两组间的iCEB无显著差异(4.37 ± 0.46 vs 4.32 ± 0.42，p = 0.456)。

结论：与非吸烟者相比，健康吸烟者iCEBc明显升高。这可能意味着健康吸烟者、患有QT延长遗传变异的慢性吸烟者或接受药物治疗的QT延长慢性吸烟者对尖端扭转型室性心动过速诱发的VA的易感性增加。

文献来源：Özdemir L, Sökmen E. Effect of habitual cigarette smoking on the index of cardiac electrophysiological balance in apparently healthy individuals.J Electrocardiol. 2020,59:41-44

Effect of habitual cigarette smoking on the index of cardiac electrophysiological balance in apparently healthy individuals

BACKGROUND AND AIM:Chronic cigarette smoking has been suggested to portend risk for cardiac arrhythmia generation. Index of cardiac electrophysiological balance (iCEB) is a relatively new ECG parameter indicating balance between ventricular depolarization and repolarization, thereby providing more insight concerning ventricular arrhythmogenesis (VA) than other classical ECG parameters such as QT and corrected QT (QTc) intervals. The present study aimed to assess the status of iCEB in healthy habitual smokers.

METHODS:This retrospective study included a total of 80 apparently healthy subjects (45% female, mean age 39.4 ± 8.1 years) with smoking habit and 82 healthy non-smoking subjects (40% female, mean age 37.0 ± 8.6 years) were included between January-September 2019. Demographic, clinical and ECG characteristics were obtained from medical records. iCEB and corrected iCEB values were calculated by dividing respective QT and QTc intervals by QRS duration.

RESULTS:Mean PR, QRS and QT intervals were similar between the groups, whereas mean heart rate and QTc interval were greater in the smoker group compared with the non-smokers [(82.0 ± 8.9 bpm vs 77.8 ± 12.4 bpm, respectively, p = 0.016) and (427.05 ± 22.6 msec vs 399.9 ± 12.8 msec, respectively, p < 0.001)]. Subject with smoking habit had greater iCEBc than the controls (5.10 ± 0.49 vs 4.68 ± 0.39, respectively, p < 0.001). However, there was no significant difference in regard of iCEB between the groups (4.37 ± 0.46 vs 4.32 ± 0.42, respectively, p = 0.456).

CONCLUSION:iCEBc increases significantly in healthy smokers compared with non-smokers. This may suggest an increased predisposition to Torsades de Pointes-mediated VA in healthy smokers, or in chronic smokers with inherent QT-prolonging genetic variations or those on QT-prolonging drug therapy.