冠状动脉慢性完全闭塞病变患者碎裂QRS波与血运重建术后心功能改善的关系

Relationship between cardiac function and fragmented QRS complex after coronary revascularization in patients with chronic total occlusion

目的:观察冠状动脉慢性完全闭塞病变(CTO)患者接受经皮冠状动脉介入(PCI)术后心功能的改善情况以及合并碎裂QRS波的关系。方法:通过回顾性分析2010-01-2014-10成功行PCI治疗的260例CTO患者,根据入院时12导联心电图的QRS波形态分为碎裂QRS波组(fQRS组,76例)和无碎裂QRS波组(nfQRS组,184例),随访分析两组患者PCI术后6个月心功能的改善情况是否存在差异。结果:两组患者PCI术后左室射血分数(LVEF)增加,左室舒张末容积指数(LVEDVI)减少,NYHA心功能分级明显改善,但和fQRS波相比,nfQRS波组的患者LVEF[(42.1±3.51)%∶(53.26±4.47)%,P<0.05]增加更显著,LVEDVI[(85.3±8.29)ml/m^2∶(76.14±8.05)ml/m^2,P<0.05]减少更明显,NYHA心功能分级亦有明显改善(P<0.05)。结论:血运重建治疗能够改善CTO患者的心功能,不合并fQRS波的患者较合并fQRS患者改善更显著。

Objective：To observe the cardiac function after percutaneous coronary intervention（PCI）and the relationship between cardiac function and fragmented QRS（fQRS）complex in patients with chronic total occlusion.Method：The patients（n=260）with successful CTO intervention were included from January 2010 to October 2014 and divided into fQRS（n=76）and non-fQRS group（n=184）based on the QRS complex types in ECG before PCI.The difference in the changes of cardiac function after PCI for 6months were analyzed between two groups.Result：After PCI for 6months in two groups,left ventricular ejection fraction（LVEF）increased,left ventricular end-diastolic volume index（LVEDVI）decreased,and the NYHA class was also significantly improved.Compared with fQRS group,non-fQRS group had more significant increase of LVEF[（42.1±3.51）% vs.（53.26±4.47）%,P〈0.05],more significant decrease of LVEDVI[（85.3±8.29）ml/m^2 vs.（76.14±8.05）ml/m^2,P〈0.05]and more significant improvement of NYHA class（P〈0.05）.Conclusion：PCI can improve the cardiac function in the patients with CTO,and cardiac function in the patients without fQRS is improved more significantly than in those with fQRS.