心电图T波峰-末间期在评价慢性心力衰竭患者心功能和左心室重构中的临床意义

Clinical significance of T-peak-end interval of electrocardiogram in evaluating cardiac function and left ventricular remodeling in patients with chronic heart failure

目的探讨心电图T波峰-末间期(Tp-Te)在评价慢性心力衰竭患者心功能和左心室重构的临床意义。方法2015年1月至2017年12月收治的慢性心力衰竭患者226例为研究对象,按照Tp-Te四分位间距分为Q1组、Q2组、Q3组、Q4组。比较4组患者一般资料和实验室检查指标。结果4组患者病程、收缩压、高血压病史比例、左心室射血分数(LVEF)、短轴缩短率(FS)、左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室质量指数(LVMI)、N末端脑钠肽前体(NT-pro BNP)、NYHA分级Ⅲ~Ⅳ比例差异均有统计学意义(P<0.05或0.01),Q4组LVEF和FS低于Q1、Q2和Q3组,其余指标均高于另3组(P<0.05);NYHA心功能分级Ⅰ级到Ⅳ级患者,Tp-Te逐渐延长(P<0.05)。Spearmen相关性研究显示Tp-Te与LVEF、FS呈负相关,与LVEDd、LVESd、LVMI、NT-pro BNP、NYHA分级呈正相关(均P<0.05)。结论心电图Tp-Te延长与慢性心力衰竭患者心功能恶化及左心室重构相关。

Objective To investigate the clinical significance of T-peak-end interval(Tp-Te)in evaluating cardiac function and left ventricular remodeling in patients with chronic heart failure(CHF).Methods A total of 226 CHF patients admitted from January 2015 to December 2017 were enrolled and were divided into Q1 group,Q2 group,Q3 group and Q4 group according to quartile of Tp-Te.General data and laboratory examination results were analyzed and compared between groups.Results There were significant differences of disease course,systolic blood pressure,ratio of hypertension history,left ventricular ejection fraction(LVEF),fraction shortening(FS),left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESd),left ventricular mass index(LVMI),NT-pro BNP and the ratio of NYHA grade III-IV among four groups(P<0.05 or 0.01).LVEF and FS were significantly lower and other parameters were significantly higher in Q4 group than Q1,Q2 and Q3 group.Tp-Te was gradually prolonged from NYHA grade I to IV patients.Spearmen correlation showed that Tp-Te was negatively correlated with LVEF and FS,respectively,and positively correlated with LVEDd,LVESd,LVMI,NT-pro BNP and NYHA classification,respectively(P<0.05).Conclusion The prolongation of Tp-Te in ECG is related to the deterioration of cardiac function and left ventricular remodeling in CHF patients.