慢性心衰患者QRS时程和新发房颤的相关性研究

Correlation of QRS duration with new-onset atrial fibrillation with chronic heart failure

目的 探讨慢性心衰患者QRS时程（QRSd）增宽对新发房颤的预测价值.方法 选择患有心衰但无房颤病史的患者1098例,将其分为三组：QRSd≤120 ms、120 ms〈QRSd〈150 ms及QRSd≥150 ms组,随访跟踪各组新发房颤的概率.通过二元分析和多元logistic回归分析探讨QRS时程和房颤新发概率之间的相关性.结果 对患者群体的统计表明,房颤的新发概率为35.7%.通过二元分析发现,房颤的新发概率存在组间差别（21.7%、35.9%、42.5%,P〈0.01）;进一步通过多元回归发现,QRS时程是独立的影响因素.结论 QRS是慢性心衰患者新发房颤的独立预测因素.

Objective To investigate the predictive value of QRS duration （QRSd） to new-onset atrial fibrillation with chronic heart failure. Methods 1098 patients with chronic heart failure but without atrial fibrillation history were selected for follow-up studies. They were divided into three groups （QRSd ≤ 120 ms, 120 ms〈 QRSd〈150 ms and QRSd≥ 150 ms）, and the new-onset probability of atrial fibrillation were recorded. The correlations between the QR$ duration and the probability of new-onset atrial fibrillation were analyzed by bivariate analysis and muhivariable logistic regression. Results In cohort analysis, the new-onset probability is 35.7%. According to the bivariate analysis, there was obvious difference with the probability of new-onset atrial fibrillation between three groups （21.7%, 35.9%, 42.5%, P〈0.01）. Furthermore, multivariate logistic regression shows that QRS duration was an independent predictive factor for new-onset atrial fibrillation. Conclusion QRS duration can be an independent predictive factor for the new-onset of atrial fibrillation to patients with chronic heart failure.