完全性左束支传导阻滞患者QRS时限与左心室射血分数的相关性

Correlation between QRS complex duration and left ventricular ejection fraction in patients with complete left bundle branch block

目的:探讨完全性左束支传导阻滞(CLBBB)患者QRS时限与左室射血分数(LVEF)的相关性。方法:选择2012年2月至2013年6月在我院经心电图诊断为左束支传导阻滞的患者213例。根据QRS波时限,患者被分为CLBBB组(182例)和不完全性左束支传导阻滞组(ICLBBB组,31例)。应用线性相关分析分析QRS波时限与LVEF的相关性,使用受试者工作特征曲线(ROC)分析QRS波时限预测LVEF<50%的最佳临界点。结果:与ICLBBB组比较,CLBBB组QRS波时限[(104.61±8.85)ms比(149.36±17.25)ms]显著升高,LVEF[(54.26±4.96)%比(45.22±12.57)%]显著降低,P均<0.01。线性相关分析显示,CLBBB患者QRS波时限与LVEF呈显著负相关(r=-0.55,P=0.001)。ROC曲线分析QRS波时限预测LVEF<50%的最佳临界点为151ms,曲线下面积为0.79(P=0.001),敏感性为68.1%,特异性为83.5%。结论:完全性左束支阻滞患者的QRS波时限与左室射血分数显著负相关,可以作为临床预测左室射血分数减低的一个简便指标。

Objective： To explore correlation between QRS complex duration and left ventricular ejection fraction （LVEF） in patients with complete left bundle branch block （CLBBB）. Methods： A total of 213 patients, who were diagnosed as left bundle branch block by ECG in our hospital from Feb 2012 to Jun 2013, were selected. According to QRS complex duration, patients were divided into CLBBB group （n = 182） and incomplete left bundle branch block （ICLBBB） group （n = 31）. Linear correlation analysis was used to analyze the correlation between QRS complex duration and LVEF, and receiver operating characteristic curve （ROC） was used to analyze optimal cutoff point of QRS complex duration for predicting LVEF〈50%. Results. Compared with ICLBBB group, there was signifi- cant rise in QRS complex duration [ （104. 61 ± 8.85） ms vs. （149.36 ± 17.25） ms] and significant reduction in LVEF [- （54. 26 ± 4. 96）% vs. （45.22 ± 12.57）%] in CLBBB group, P〈0.01 both. Linear correlation analysis indicated that QRS complex duration was significant inversely correlated with LVEF （r = - 0. 55, P = 0. 001） in CLBBB pa- tients. ROC analysis indicated that optimal cutoff point of QRS complex duration for predicting LVEF〈50% was 151ms, the area under the curve was 0.79 （P = 0. 001）, its sensitivity was 68.1% and specificity was 83.5%. Con- clusion： QRS complex duration is significant inversely correlated with LVEF in CLBBB patients, which can be used as a simple index predicting reduced LVEF.