心肌做功指数与慢性心力衰竭患者心脏再同步治疗后室性心律失常的相关性研究

Analysis of the relativity between Tei index and ventricular tachyarrhythmias in chronic heart failure after cardiac resynchronization therapy

目的 探讨心肌做功指数（Tei指数）与慢性心力衰竭患者心脏再同步化治疗（CRT）后发生室性快速性心律失常的关系.方法 选取2009年7月至2013年10月本院心内科收治的51例行CRT的心力衰竭患者,术前行超声心动图检查并计算Tei指数,术后随访1年,起搏器程控仪分析随访期间持续性室性心动过速（VT）、心室颤动（VF）的发生次数.结果 共完成随访48例,其中无事件组33例（68.8％）,VT/VF组15例（31.2％）.两组左室射血分数（LVEF）、左房最大内径（LAD）、E峰与A峰比值（E/A）比较未见统计学差异（P＞0.05）.VT/VF组左室舒张末期内径（LVEDD）、Tei指数显著高于无事件组,差异有统计学意义（P值分别为0.034、0.013）.Tei指数与VT/VF的发生次数呈显著正相关（r=0.834,P＜0.01）,而LVEDD与VT/VF的发生次数无显著相关性（r=0.065,P＞0.05）.结论 Tei指数是慢性心力衰竭患者CRT后发生室性快速性心律失常强有力的预测因子.

Objective To evaluate the impact of Tei index on ventricular tachyarrhythmias with chronic heart failure patients after cardiac resynchronization therapy （CRT）. Methods 51 patients with chronic heart fail- ure hospitalized in our cardiology department from July 2009 to October 2013 were involved, these patients will undergo CRT, before implantation Echocardiographie data and Tel index were detected. The patients were followed for one year, during which the number of sustained ventricular tachycardia （VT） and ventricular fibrillation（VF） happened were recorded by the CRT pacemaker and analyzed by program recording control instrument. Results Follow-up data were obtained from 48 patients, of them, 33 patients（68.8% ） had no events, 15 patients（31.2% ） had happened VT or VF, the level of LVEF, LAD, E/A ratio had no significant differences between the two group （P〉0.05）. LVEDD, Tei index level in VT/VF group were significantly high than in the no events group （P= 0.035, 0.013 respectively）. Tei index correlated positively with the number of VT/VF（r=0.834, P〈0.01 ）. No sig- nificant correlation between them with LVEDD（r=0.065, P〉0.05）. Conclusion Tel index was a strong and accu- rate prognosticator in identifying patients of chronic heart failure after CRT who are at high risk of ventricular tach- yarrhythmias.