BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis ...BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been elucidated.At the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely unknown.AIM To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver Tx.METHODS In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after 1998.Seventy-three studies were considered eligible.Data concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were retrieved.The Newcastle-Ottawa quality assessment scale appraised the quality of the eligible studies.Effect estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and Laird.Subgroup,sensitivity analysis,and meta-regressions were applied to assess heterogeneity.RESULTS QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterogeneity(I2=97.5%;95%CI:97.2%-97.8%);both Egger’s and Begg’s tests showed non-significance.QTc was elongated in patients with cirrhosis compared with controls(P<0.001).QTc was longer in patients with Child-Pugh C cirrhosis when compared with Child-Pugh B and A(P<0.001);Child-Pugh B patients presented longer QTc when compared with Child-Pugh A patients(P=0.003).The MELD score was higher in patients with cirrhosis with QTc>440 ms when compared with QTc≤440 ms(P<0.001).No correlation of QTc with age(P=0.693),sex(P=0.753),or etiology(P=0.418)was detected.β-blockers shortened QTc(P<0.001).QTc was prolonged during acute gastrointestinal bleeding(P=0.020).Tx tended to improve QTc(P<0.001).No other sources of QTc heterogeneity were revealed.CONCLUSION QTc is prolonged in cirrhosis independently of sex,age,and etiology but is correlated with severity and affected byβ-blockers and acute gastrointestinal bleeding.QTc is improved after liver Tx.展开更多
Objective： To evaluate the changes in Tp-e interval （an interval from the peak to the end of the T wave）, QT interval and Tp-e/QT ratio of the body surface ECG in patients with left ventricular hypertrophy （LVH）....Objective： To evaluate the changes in Tp-e interval （an interval from the peak to the end of the T wave）, QT interval and Tp-e/QT ratio of the body surface ECG in patients with left ventricular hypertrophy （LVH）. Methods： The Tp-e interval and QT interval were measured on body surface ECGs in 42 patients without either hypertension or LVH （control group）, 41 patients having hypertension but not LVH （non-LVH group）, and 38 patients with both hypertension and LVH （LVH group）. Results： The mean corrected QT （QTc） interval, and mean corrected Tp-e[T（p-e）c] interval were significantly longer in the LVH group （0.430±0.021s vs. 0.409±0.019s, p 〈 0.01; 0.098±0.013s vs. 0.088±0.011s, respectively） than those in the control group. The Tp-e/QT ratio was also amplified in LVH group （0.232± 0.028 vs.0.218± 0.027） （p 〈 0.05）. Conclusion： LVH increased the QT interval, Tp-e interval and Tp-e/QT ratio of the body surface ECG.展开更多
Objective:Accurate measurement of QT interval,the ventricular action potential from depolarization to repolarization,is important for the early detection of Long QT syndrome.The most effective QT correction(QTc)formul...Objective:Accurate measurement of QT interval,the ventricular action potential from depolarization to repolarization,is important for the early detection of Long QT syndrome.The most effective QT correction(QTc)formula has yet to be determined in the pediatric population,although it has intrinsically greater extremes in heart rate(HR)and is more susceptible to errors in measurement.The authors of this study compare six dif-ferent QTc methods(Bazett,Fridericia,Framingham,Hodges,Rautaharju,and a computer algorithm utilizing the Bazett formula)for consistency against variations in HR and RR interval.Methods:Descriptive Retrospective Study.We included participants from a pediatric cardiology practice of a community hospital who had an ECG performed in 2017.All participants were healthy patients with no past medical history and no regular med-ications.Results:ECGs from 95 participants from one month to 21 years of age(mean 9.7 years)were included with a mean HR of 91 beats per minute(bpm).The two-sample paired t-test or Wilcoxon signed-rank test assessed for any difference between QTc methods.A statistically significant difference was observed between every combination of two QTc formulae.The Spearman’s rank correlation analysis explored the QTc/HR and QTc/RR relationships for each formula.Fridericia method was most independent of HR and RR with the lowest absolute value of correlation coefficients.Bazett and Computer had moderate correlations,while Framingham and Rautaharju exhibited strong correlations.Correlations were positive for Bazett and Computer,reflecting results from prior studies demonstrating an over-correction of Bazett at higher HRs.In the linear QTc/HR regression analysis,Bazett had the slope closest to zero,although Computer,Hodges,and Fridericia had comparable values.Alternatively,Fridericia had the linear QTc/RR regression coefficient closest to zero.The Bland-Altman method assessed for bias and the limits of agreement between correction formulae.Bazett and Computer exhibited good agreement with minimal bias along with Framingham and Rautaharju.To account for a possible skewed distri-bution of QT,all the above analyses were also performed excluding the top and bottom 2%of data as sorted by heart rate ranges(N=90).Results from this data set were consistent with those derived from all participants(N=95).Conclusions:Overall,the Fridericia correction method provided the best rate correction in our pedia-tric study cohort.展开更多
目的:国外文献提示运动平板试验QT间期延长是长QT综合征(LQTS)的表现之一,但国内常规运动平板试验检查未测量分析QT/校正QT(QTc)间期。本研究旨在探索运动平板试验作为国人LQTS辅助诊断操作流程的可行性和有效性。方法:前瞻性连续入选2...目的:国外文献提示运动平板试验QT间期延长是长QT综合征(LQTS)的表现之一,但国内常规运动平板试验检查未测量分析QT/校正QT(QTc)间期。本研究旨在探索运动平板试验作为国人LQTS辅助诊断操作流程的可行性和有效性。方法:前瞻性连续入选2023年7月至2024年7月在中国医学科学院阜外医院行运动平板试验者80例,包括健康对照37例、常见心血管疾病患者25例及基因和临床诊断或疑诊LQTS患者18例,即健康对照组、常见心血管疾病组和疑诊LQTS组。研究对象均行本研究设置的辅助诊断LQTS的运动平板试验检查方案,即在运动平板试验开始前卧位、坐位、立位及运动峰值、恢复期1 min和4 min共6个时间点记录12导联心电图并测量QTc间期。对比3组研究对象在上述6个时间点的QTc间期差异。结果:健康对照组和常见心血管疾病组在运动平板试验检查前后6个时间点的QTc间期均<480 ms,且两组差异均无统计学意义(P均>0.05)。疑诊LQTS组恢复期4 min QTc间期≥480 ms者占66.7%(12/18),其中5例基因检测有明确LQTS致病基因突变(包括1例基因诊断LQTS1型,卧位心电图QTc间期489 ms,恢复期4 min QTc间期636 ms);5例为Schwartz评分≥4分临床确诊患者(基因检测阴性或未检测),另2例Schwartz评分为3分。疑诊LQTS组恢复期4 min QTc间期在445~480 ms者占27.8%(5/18),包括2例临床Schwartz评分≥4分和3例临床疑诊(Schwartz评分2~3分)患者。还有1例临床疑诊(Schwartz评分3分)患者恢复期4 min QTc间期<445 ms,后期基因检测阴性。受试者工作特征(ROC)曲线分析显示,恢复期4 min QTc间期≥482 ms辅助诊断LQTS的灵敏度为83.3%、特异度为98.4%。结论:测量多个时间点QTc间期的运动平板试验检查方案能够有效识别LQTS,在临床实践中有较强的可行性和推广性。展开更多
In recent years,the global installed capacity of wind power has grown rapidly,making the enhancement of wind power prediction accuracy crucial for facilitating the integration and consumption of renewable energy.Curre...In recent years,the global installed capacity of wind power has grown rapidly,making the enhancement of wind power prediction accuracy crucial for facilitating the integration and consumption of renewable energy.Current research on ultra-short-term wind power prediction often overlooks load characteristics,resulting in an inability to adequately address grid connection requirements and load dispatching demands across different time periods.To address this limitation,this study proposes a novel approach to ultra-short-term wind power prediction error correction that incorporates load peak-valley characteristics.The methodology involves three key steps:first,deriving interannual prediction error characteristics from ultra-short-term prediction results of wind farm clusters;second,establishing error correction intervals for load peak and valley periods,calculating corresponding correction coefficients,and analyzing the impact of varying correction radii on the final results;third,validating the proposed method through empirical analysis of wind farm clusters in three northeastern provinces.The results demonstrate that this approach not only improves wind power prediction accuracy but also significantly reduces the occurrence of harmful error days,thereby better meeting the operational requirements of power system dispatch.展开更多
文摘BACKGROUND Corrected QT(QTc)interval is prolonged in patients with liver cirrhosis and has been proposed to correlate with the severity of the disease.However,the effects of sex,age,severity,and etiology of cirrhosis on QTc have not been elucidated.At the same time,the role of treatment,acute illness,and liver transplantation(Tx)remains largely unknown.AIM To determine the mean QTc in patients with cirrhosis,assess whether QTc is prolonged in patients with cirrhosis,and investigate whether QTc is affected by factors such as sex,age,severity,etiology,treatment,acute illness,and liver Tx.METHODS In the present systematic review and meta-analysis,the searching protocol“{[QTc]OR[QT interval]OR[QT-interval]OR[Q-T syndrome]}AND{[cirrhosis]OR[Child-Pugh]OR[MELD]}”was applied in PubMed,EMBASE,and Google Scholar databases to identify studies that reported QTc in patients with cirrhosis and published after 1998.Seventy-three studies were considered eligible.Data concerning first author,year of publication,type of study,method used,sample size,mean age,female ratio,alcoholic etiology of cirrhosis ratio,Child-Pugh A/B/C ratio,mean model for end-stage liver disease(MELD)score,treatment withβ-blockers,episode of acute gastrointestinal bleeding,formula for QT correction,mean pulse rate,QTc in patients with cirrhosis and controls,and QTc according to etiology of cirrhosis,sex,Child-Pugh stage,MELD score,and liver Tx status(pre-Tx/post-Tx)were retrieved.The Newcastle-Ottawa quality assessment scale appraised the quality of the eligible studies.Effect estimates,expressed as proportions or standardized mean differences,were combined using the randomeffects,generic inverse variance method of DerSimonian and Laird.Subgroup,sensitivity analysis,and meta-regressions were applied to assess heterogeneity.RESULTS QTc combined mean in patients with cirrhosis was 444.8 ms[95%confidence interval(CI):440.4-449.2;P<0.001 when compared with the upper normal limit of 440 ms],presenting high heterogeneity(I2=97.5%;95%CI:97.2%-97.8%);both Egger’s and Begg’s tests showed non-significance.QTc was elongated in patients with cirrhosis compared with controls(P<0.001).QTc was longer in patients with Child-Pugh C cirrhosis when compared with Child-Pugh B and A(P<0.001);Child-Pugh B patients presented longer QTc when compared with Child-Pugh A patients(P=0.003).The MELD score was higher in patients with cirrhosis with QTc>440 ms when compared with QTc≤440 ms(P<0.001).No correlation of QTc with age(P=0.693),sex(P=0.753),or etiology(P=0.418)was detected.β-blockers shortened QTc(P<0.001).QTc was prolonged during acute gastrointestinal bleeding(P=0.020).Tx tended to improve QTc(P<0.001).No other sources of QTc heterogeneity were revealed.CONCLUSION QTc is prolonged in cirrhosis independently of sex,age,and etiology but is correlated with severity and affected byβ-blockers and acute gastrointestinal bleeding.QTc is improved after liver Tx.
文摘Objective： To evaluate the changes in Tp-e interval （an interval from the peak to the end of the T wave）, QT interval and Tp-e/QT ratio of the body surface ECG in patients with left ventricular hypertrophy （LVH）. Methods： The Tp-e interval and QT interval were measured on body surface ECGs in 42 patients without either hypertension or LVH （control group）, 41 patients having hypertension but not LVH （non-LVH group）, and 38 patients with both hypertension and LVH （LVH group）. Results： The mean corrected QT （QTc） interval, and mean corrected Tp-e[T（p-e）c] interval were significantly longer in the LVH group （0.430±0.021s vs. 0.409±0.019s, p 〈 0.01; 0.098±0.013s vs. 0.088±0.011s, respectively） than those in the control group. The Tp-e/QT ratio was also amplified in LVH group （0.232± 0.028 vs.0.218± 0.027） （p 〈 0.05）. Conclusion： LVH increased the QT interval, Tp-e interval and Tp-e/QT ratio of the body surface ECG.
基金This study was reviewed and approved by the New York-Presbyterian Brooklyn Methodist Hospital Institutional Review Committee.The study follows the guidelines outlined in the Declaration of Helsinki.
文摘Objective:Accurate measurement of QT interval,the ventricular action potential from depolarization to repolarization,is important for the early detection of Long QT syndrome.The most effective QT correction(QTc)formula has yet to be determined in the pediatric population,although it has intrinsically greater extremes in heart rate(HR)and is more susceptible to errors in measurement.The authors of this study compare six dif-ferent QTc methods(Bazett,Fridericia,Framingham,Hodges,Rautaharju,and a computer algorithm utilizing the Bazett formula)for consistency against variations in HR and RR interval.Methods:Descriptive Retrospective Study.We included participants from a pediatric cardiology practice of a community hospital who had an ECG performed in 2017.All participants were healthy patients with no past medical history and no regular med-ications.Results:ECGs from 95 participants from one month to 21 years of age(mean 9.7 years)were included with a mean HR of 91 beats per minute(bpm).The two-sample paired t-test or Wilcoxon signed-rank test assessed for any difference between QTc methods.A statistically significant difference was observed between every combination of two QTc formulae.The Spearman’s rank correlation analysis explored the QTc/HR and QTc/RR relationships for each formula.Fridericia method was most independent of HR and RR with the lowest absolute value of correlation coefficients.Bazett and Computer had moderate correlations,while Framingham and Rautaharju exhibited strong correlations.Correlations were positive for Bazett and Computer,reflecting results from prior studies demonstrating an over-correction of Bazett at higher HRs.In the linear QTc/HR regression analysis,Bazett had the slope closest to zero,although Computer,Hodges,and Fridericia had comparable values.Alternatively,Fridericia had the linear QTc/RR regression coefficient closest to zero.The Bland-Altman method assessed for bias and the limits of agreement between correction formulae.Bazett and Computer exhibited good agreement with minimal bias along with Framingham and Rautaharju.To account for a possible skewed distri-bution of QT,all the above analyses were also performed excluding the top and bottom 2%of data as sorted by heart rate ranges(N=90).Results from this data set were consistent with those derived from all participants(N=95).Conclusions:Overall,the Fridericia correction method provided the best rate correction in our pedia-tric study cohort.
文摘目的:国外文献提示运动平板试验QT间期延长是长QT综合征(LQTS)的表现之一,但国内常规运动平板试验检查未测量分析QT/校正QT(QTc)间期。本研究旨在探索运动平板试验作为国人LQTS辅助诊断操作流程的可行性和有效性。方法:前瞻性连续入选2023年7月至2024年7月在中国医学科学院阜外医院行运动平板试验者80例,包括健康对照37例、常见心血管疾病患者25例及基因和临床诊断或疑诊LQTS患者18例,即健康对照组、常见心血管疾病组和疑诊LQTS组。研究对象均行本研究设置的辅助诊断LQTS的运动平板试验检查方案,即在运动平板试验开始前卧位、坐位、立位及运动峰值、恢复期1 min和4 min共6个时间点记录12导联心电图并测量QTc间期。对比3组研究对象在上述6个时间点的QTc间期差异。结果:健康对照组和常见心血管疾病组在运动平板试验检查前后6个时间点的QTc间期均<480 ms,且两组差异均无统计学意义(P均>0.05)。疑诊LQTS组恢复期4 min QTc间期≥480 ms者占66.7%(12/18),其中5例基因检测有明确LQTS致病基因突变(包括1例基因诊断LQTS1型,卧位心电图QTc间期489 ms,恢复期4 min QTc间期636 ms);5例为Schwartz评分≥4分临床确诊患者(基因检测阴性或未检测),另2例Schwartz评分为3分。疑诊LQTS组恢复期4 min QTc间期在445~480 ms者占27.8%(5/18),包括2例临床Schwartz评分≥4分和3例临床疑诊(Schwartz评分2~3分)患者。还有1例临床疑诊(Schwartz评分3分)患者恢复期4 min QTc间期<445 ms,后期基因检测阴性。受试者工作特征(ROC)曲线分析显示,恢复期4 min QTc间期≥482 ms辅助诊断LQTS的灵敏度为83.3%、特异度为98.4%。结论:测量多个时间点QTc间期的运动平板试验检查方案能够有效识别LQTS,在临床实践中有较强的可行性和推广性。
基金supported by the National Key R&D Program of China(Technology and application of wind power/photovoltaic power prediction for promoting renewable energy consumption(2018YFB0904200).
文摘In recent years,the global installed capacity of wind power has grown rapidly,making the enhancement of wind power prediction accuracy crucial for facilitating the integration and consumption of renewable energy.Current research on ultra-short-term wind power prediction often overlooks load characteristics,resulting in an inability to adequately address grid connection requirements and load dispatching demands across different time periods.To address this limitation,this study proposes a novel approach to ultra-short-term wind power prediction error correction that incorporates load peak-valley characteristics.The methodology involves three key steps:first,deriving interannual prediction error characteristics from ultra-short-term prediction results of wind farm clusters;second,establishing error correction intervals for load peak and valley periods,calculating corresponding correction coefficients,and analyzing the impact of varying correction radii on the final results;third,validating the proposed method through empirical analysis of wind farm clusters in three northeastern provinces.The results demonstrate that this approach not only improves wind power prediction accuracy but also significantly reduces the occurrence of harmful error days,thereby better meeting the operational requirements of power system dispatch.
