QT间期离散度(QTd)对心脏同步化治疗评估研究

Influence of cardiac resynchronization therapy on QTd

目的:观察心脏再同步治疗(CRT)对心肌复极离散的影响。方法:选取68例接受CRT植入的心力衰竭患者,根据术后6个月左心室射血分数绝对值是否较基线水平升高绝对值是否较基线水平提高≥10%,分为反应组(n=34)和无反应组(n=34)。比较两组患者CRT植入后不同时期QRS间期、QT间期复极离散度指标变化情况。结果:反应组患者术后1年QRS间期和QTd间期较术前和术后<24 h均明显缩短,差异有统计学意义(P<0.05),而无反应组各时期上述指标差异均无统计学意义,差异有统计学意义(P>0.05);68例患者中,CRT术后有22例出现室性心律失常,QTd间期在室性心律失常组较非室性心律失常组明显延长,差异有统计学意义(P<0.05)。结论:QTd在对CRT治疗患者术后的有效性是很好的评价指标。

Objective To investigate the effects of cardiac resynchronization therapy（CRT） in patients with dispersion of re-polarization and ventricular arrhythmia. Method 68 patients with biventricular pacemaker were included in this study. According to weather absolute value of LVEF increased≥10% from baseline at 6 months after CRT implantation,the patients were divided into 2 groups： Response group（n = 34） and Non-response group（n = 34）. Dispersion of re-polarization indexes as QRS duration,QT interval and the events of ventricular arrhythmia were compared between 2 groups at different time points after CRT. Results In Response group,compared with pre-operation,QRS duration and QTd interval were shorter at 1 year and within 24 h after CRT implantation,all P〈0. 05,while the above indexes were similar in Non-response group,all P〈0. 05. Among 68 patients,there were 22 with ventricular arrhythmias（AV） after CRT. QTd interval were significantly longer in AV patients than those in non-AV patients（P〈0. 05）. Conclusion CRT ventricular reverse remodeling may reduce dispersion of re-polarization. The incidence of AV is correlated to the extension of QTd interval of cardiac resynchronization therapy（CRT）in patients.