P波离散度对肥厚型心肌病患者发生房颤的预测价值

P wave dispersion as a predictor for atrial fibrillation development in patients with hypertrophic cardiomyopathy

目的评价P波离散度及左房内径对肥厚型心肌病患者发生房颤的预测价值。方法158例肥厚型心肌病患者按是否伴有房颤分为房颤组和非房颤组,分别测量两组患者的心电图P波最大时限、P波最小时限并计算P波离散度,同时用超声心动图测量左房内径,并进行比较。结果158例患者中,32例患者伴房颤(20.3%)。其中阵发性房颤14例(43.7%),持续性房颤18例(57.3%),无症状性房颤5例(15.6%);房颤组与非房颤组P波最大时限、P波离散度及左房内径明显增加(p<0.01);房颤组与非房颤组患者比较,心电图P波最大时限>140ms、P波离散度>40ms和左房直径>42mm有显著性差异。结论肥厚型心肌病伴房颤患者中无症状性房颤较常见;P波最大时限>140ms、P波离散度>40ms和左房直径>42mm是预测发生房颤的可靠指标。

Objective To evaluate the predictive value of P wave dispersion and left atrial diameter to atrial fibrillation（AF） in hypertrophic cardiomyopathy（HCM）patients. Methods 158 cases of HCM patients were divided into 2 groups： A F group and non-AF group, Maximum P wave duration, minimum P wave duration and P wave dispersion were measured. And the left atrial diameter was tested by ultrasonic cardiogram （UCG）. Results （1）32 of 158 cases of HCM patients have atrial fibrillation 14 cases of paroxysmal AF （43.7%）, 18 cases of persistent AF（15.6%）, 5 cases asymptomatic AF; （2）Pmax and Pd and left atrial diameter significantly increased in AF group （P〈0.01）; （2）Pmax〉140ms and Pd〉4Omm and left atrial diameter〉42mm is significant !n AF group than in non- AF group. Conclusion （1）Asymptgm atrial fibrillation is common in HCM patients; （2）Pmax〉140ms and Pd〉 40mm and left atrial diameter〉42mm are all useful predictive factors for atrial fibrillaion.