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陆军军医大学第一附属医院心内科
纸质出版日期:2018,
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[1]邓盛荣,舒茂琴,柴虹,宋治远.心电图预测心脏再同步化治疗效果的价值[J].保健医学研究与实践,2018,15(03):42-44+60.
Deng Shengrong, Shu Maoqin, Chai Hong, et al. The role of electrocardiograph in predicting response to cardiac resynchronization therapy[J]. Health Medicine Research and Practice, 2018,15(3):42-44.
目的探讨心电图预测心脏再同步化治疗(CRT)效果的价值。方法选取2014年1月-2016年12月在重庆市某医院接受CRT治疗的94例充血性心力衰竭患者为研究对象。于CRT术后12个月时
根据患者是否发生CRT反应将患者分为反应组(n=47)和无反应组(n=47)。探究患者的性别、年龄、合并疾病(高血压、糖尿病、室性心律失常、缺血性心肌病、完全性左束支传导阻滞)及术前、术后24hQRS时限、QTc间期及Tpe间期与患者发生CRT反应的相关性。结果术前
2组患者年龄、性别构成及合并高血压、糖尿病、室性心律失常、缺血性心肌病、完全性左束支传导阻滞比例比较
差异无统计学意义(P>0.05)。术后24h
反应组患者QRS时限、QTc间期及Tpe间期均短于术前
且反应组患者QRS时限、QTc间期及Tpe间期均短于无反应组
差异均有统计学意义(P<0.05)。术前及术后24h
无反应组患者QRS时限、QTc间期及Tpe间期比较
差异无统计学意义(P>0.05)。多因素Logistic回归分析表明
CRT术后24hQTc间期明显缩短及CRT术后24hTpe间期明显缩短是患者发生CRT反应的独立预测因素(P<0.05)。结论心电图在预测患者发生CRT反应方面具有重要价值
即CRT术后24hQTc间期明显缩短及CRT术后24hTpe间期明显缩短是患者发生CRT反应的独立预测因素。
Objective To investigate the role of electrocardiograph(ECG)in predicting response to cardiac resynchronization therapy(CRT).Methods Ninety-four patients diagnosed with congestive heart failure who underwent CRT at a hospital in Chongqing between January 2014 and December 2016 were included in this study.Based upon patient response to CRT 12 months after CRT
these patients were classified into the responsive group(n=47)and the unresponsive group(n=47).The correlation between patient response to CRT and the following variables were assessed:gender
age
comorbidities(hypertension
diabetes
ventricular arrhythmia
ischemic cardiomyopathy
and complete left bundle branch block[CLBBB])
as well as QRS duration
QTc interval and Tpe interval before and 24 hafter CRT.Results The age
gender composition
and proportions of patients with concomitant hypertension
diabetes
ventricular arrhythmia
ischemic cardiomyopathy
and CLBBB before CRT were comparable between the two groups(P>0.05).At 24 hafter CRT
the QRS duration
QTc interval and Tpe interval in the responsive group were shorter than those before CRT in the same group
also shorter than those observed in the unresponsive group(P<0.05).The QRS duration
QTc interval and Tpe interval in the unresponsive group were similar before and 24 hafter CRT(P>0.05).Multivariable Logistic regression analysis showed that
both substantial shortening of QTc interval after CRT and substantial shortening of Tpe interval 24 hafter CRT were independent predictors of patient response to CRT(P<0.05).Conclusion ECG is of great value in predicting response to CRT;substantial shortening of QTc interval and Tpe interval 24 hafter CRT were both independent predictors of patient response to CRT.
心脏再同步化治疗心电图充血性心力衰竭
Cardiac resynchronization therapyElectrocardiographCongestive heart failure
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