T波峰末间期和心率变异性在冠心病并发室速危险分层的意义

T peak-T end interval and heart rate variability in ventricular tachycardia risk stratification in patients with coronary heart disease

目的明确心电图T波峰末间期(Tpe)和心率变异性在冠心病患者并发室性心动过速(室速)危险分层中的作用。方法选取46例发生室速和23例无室速(对照组)的冠心病患者,分别测量其12导联同步动态心电图的Tpe间期和24 h心率变异性指标。结果两组间Tpe差异有统计学意义(P<0.05);两组心率变异性指标中24 h全部RR间期的标准差(SDNN)差异有统计学意义(P<0.05),Logistic多元回归分析显示Tpe是冠心病患者发生室速的独立危险因素[P<0.05,比值比(OR)为0.9499,5%CI为0.912～0.987]。结论Tpe和心率变异性是冠心病患者并发室速的重要危险因素,且Tpe是独立危险因素。

Objective Our objective in this study was to evaluate T peak - T end interval （ Tp - e） and heart rate variability as risk strati- fication for ventricular tachycardia in patients with coronary heart disease. Methods Forty - six patients with ventficular tachycardia and 23 patients without ventrieular tachycardia but age - and gender - matched controls were studied. All of them were with coronary heart disease. Their Tp - e and heart rate variability were calculated on 12 - leads ambulatory electrocardiograms. Results The patients with ventricular tachycardia had significantly greater Tp - e compared to that of control subjects （ 113.91 ＋25. 919ms vs 100.52 ± 14. 737ms, P =0. 008）. There was significant difference in the standard deviation of normal to normal intervals （SDNN） between ventricular tachycardia group and non - ventricular tachycardia group （ 138.45 ± 19.93 ms2 vs 127.28 ± 23.64 ms2, P = 0. 043 ）. Logistic regression analysis showed that Tp - e was the independent risk factor for ventricular tachycardia in patients with coronary heart disease （ P = 0. 009）. Conclusion This study indicates that Tp - e is the independent risk factor for ventricular tachycardia in patients with coronary heart disease. Abnormal HRV is also important risk factor and can be added to Tp - e for better risk stratification.