心电图预测冠状动脉慢性完全闭塞病变血运重建后心功能恢复的研究

Electrocardiogram as a predictor of functional recovery after recanalization of chronic total coronary occlusions.

目的研究心电图对冠状动脉慢性完全闭塞病变(CTO)患者血运重建术后左室功能恢复的预测作用。方法选择2005年1月至2007年6月济南市第四人民医院和山东省立医院58例CTO患者用静息12导联心电图来评价Q波及QT离散度等参数,应用实时三维超声心动图(RT-3DE)评价左室局部室壁运动情况。结果在无病理性Q波(无Q波)的患者中,室壁运动记分指数(WMSI)由1.56±0.31降低至1.12±0.21(P<0.05),而存在病理性Q波(有Q波)的患者WMSI无明显变化(1.73±0.12和1.59±0.23,P>0.05)。结论对于血运重建的CTO患者,通过分析心电图的病理性Q波能可靠地预测局部室壁运动的恢复。

Objective To determine whether the 12-lead-resting electrocardiogram （ECG） is a predictor of left vertricular （LV） recovery after successful recanalization of chronic total coronary occlusions（CTO）. Methods The 12-lead-resting ECG was evaluated for Q-wave areas and parameters of QT dispersion. Impairment of regional wall motion was evaluated by real-time three-dimensional echocardiography（RT-3DE） at baseline and at follow-up. Results The wall motion score index （WMSI） was improved from 1.56 ± 0. 31 to 1. 12 ± 0. 21 （ P 〈 0. 05 ） in patients without Q waves, whereas it was unchanged in patients with Q waves （ 1.73 ± 0. 12 and 1.59 ± 0. 23, P 〉 0. 05 ）. Conclusion In patients with recanalization of CTO,recovery of regional wall motion is reliably predicted by analysis of the 12-lead-resting ECG.