经皮冠状动脉介入治疗急性前壁心肌梗死患者QRS波时限与左心室射血分数的关系

Correlation between QRS complex duration and left ventricular ejection fraction in patients with acute anterior myocardial infarction after percutaneous coronary intervention

目的探讨经皮冠状动脉介入治疗急性前壁心肌梗死患者出院时QRS时限与左心射血分数(left ven-tricular ejection fraction,LVEF)的相关性。方法入选2012年3月至2015年3月在首都医科大学附属北京良乡医院经皮冠状动脉介入治疗的急性前壁心肌梗死患者213例,收集患者出院时心电图特征,包括是否存在房性期前收缩、是否存在室性期前收缩、心率、QRS间期、QT离散度、ST-T改变以及是否存在碎裂QRS。通过相关性分析QRS时限与患者随访期间LVEF之间的关系。结果将年龄、性别、吸烟史、原发性高血压(高血压)史、糖尿病史、冠状动脉病变支数作为控制变量,出院时以及随访期间LVEF分别与心电图各变量进行偏相关分析,结果表明出院时QRS波时限与随访期间LVEF呈显著性负相关(r=-0.488,P<0.001)。结论经皮冠状动脉介入治疗的急性前壁心肌梗死患者出院时QRS波时限与随访期间的LVEF呈负相关。

Objectives To evaluate the correlation between QRS complex duration at discharge and left ventricular ejection fraction（LVEF）in patients with acute anterior myocardial infarction after percutaneous coronary intervention. Methods A total of 213 patients with acute anterior myocardial infarction treating with percutaneous coronary interven-tion,from March 2012 to March 2015 in Beijing Liangxiang Hospital Affiliated to Capital Medical University,were in-cluded in our study. Electrocardiogram （ECG） characteristics at discharge were collected ,including the existence of atrial premature contraction or ventricular premature contraction,heart rate,QRS complex duration,QT dispersion, ST-T changes,and the existence of fragmented QRS. Correlation analysis was used to evaluate the relationship between QRS complex duration at discharge and LVEF during follow-up. Results Correlation between the electrocardiographic variables and LVEF at discharge and during follow-up were determined by partial correlation analysis. The results show that QRS complex duration at discharge was significantly negatively correlated with LVEF during follow-up（r=-0.488, P〈0.001）. Conclusions Our study suggests that QRS complex duration at discharge significantly negatively correlates with LVEF during follow-up in patients with acute anterior myocardial infarction after percutaneous coronary interven-tion.