女性非阻塞性冠状动脉疾病胸痛患者冠状动脉血流储备与QTc延长的相关性研究

Correlation between coronary blood flow reserve and QTc interval prolongation in chest pain female patients with non-obstructive coronary artery disease

目的分析女性非阻塞性冠状动脉疾病(NOCA)胸痛患者冠状动脉血流储备(CFR)与心电图校正QT间期(QTc)延长的相关性。方法选取2018年2月至2021年5月因胸痛在该院就诊的女性患者130例,冠状动脉造影无直径狭窄≥50%的病变,PET/CT定量心肌血流分析测定CFR值,依据CFR值分为CMVD组(CFR<2.0,61例)和对照组(CFR≥2.0,69例)。Bazett公式计算心电图QTc。多因素logistic回归模型分析CFR与QTc延长的相关性。结果CMVD组QTc明显高于对照组[(430.9±18.3)ms vs.(419.7±21.9)ms,P<0.05]。logistic模型回归分析显示,经年龄、体重指数、低密度脂蛋白胆固醇(LDL-C)、血钾、糖尿病、吸烟、高血压校正,CFR与QTc延长呈负相关,CFR每增加0.5,减少QTc延长的OR为0.619(95%CI:0.416~0.920,P<0.05);LDL-C与QTc延长呈正相关,OR为1.915(95%CI:1.133~3.236,P<0.05)。结论在女性NOCA患者中,CFR降低和LDL-C升高是QTc延长的危险因素。

Objective To analyze the correlation between coronary flow reserve(CFR)and corrected QT interval(QTc)prolongation in chest pain female patients with non-obstructive coronary artery disease(NOCA).Methods A total of 130 female patients with chest pain admitted to this hospital from February 2018 to May 2021 were selected.No lesion with the vessel diameter stenosis≥50%was detected by coronary angiography.The CFR value was determined by the PET/CT quantitative myocardial flow analysis.The patients were divided into the CMVD group(CFR<2.0,61 cases)and control group(CFR≥2.0,69 cases)according to the CFR value.The QTc interval in ECG was calculated by the Bazett formula.The multivariate logistic regression model was used to analyze the relationship between CFR and QTc prolongation.Results The QTc interval in the CMVD group was significantly higher than that in the control group[(430.9±18.3)ms vs.(419.7±21.9)ms,P<0.05].The logistic model regression analysis showed that CFR was negatively correlated with QTc prolongation after adjusting by age,body mass index,low density lipoprotein(LDL-C),blood potassium,diabetes mellitus,smoking and hypertension,the OR of decreasing QTc prolongation was 0.619 when each CFR was increased by 0.5(95%CI:0.416-0.920,P<0.05).LDL-C was positively correlated with QTc prolongation,OR was 1.915(95%CI:1.133-3.236,P<0.05).Conclusion In female patients with NOCA,the CFR decrease and LDL-C increase are the risk factors for QTc interval prolongation.