冠状动脉侧支循环及PCI治疗对CTO患者Tp-e间期、Tp-e/QT比值的影响

Influence of coronary collateral circulation and percutaneous coronary intervention on Tp-e interval and Tp-e/QT ratio in patients with chronic total coronary occlusion

目的探讨冠状动脉侧支循环(coronary collateral circulation,CCC)对冠状动脉慢性完全闭塞病变(chronic total coronary occlusion,CTO)患者Tp-e间期、Tp-e/QT比值的影响,以及经皮冠状动脉介入(percutane⁃ous coronary intervention,PCI)治疗对CTO患者Tp-e间期、Tp-e/QT比值的影响及临床意义。方法本研究选取邵阳市中心医院心内科2018年7月至2020年12月期间CTO患者共150例。CCC采用Rentrop评分进行分级,将入选患者分为CCC不良组(Rentrop 0级、1级组),CCC良好组(Rentrop 2级、3级组)。测量各组患者心电图中Tp-e间期、Tp-e/QT比值。另从以上研究对象中按是否成功行PCI治疗分为PCI治疗成功组及PCI治疗失败组。观察两组患者PCI治疗前及治疗后心电图中Tp-e间期、Tp-e/QT比值的情况。结果CCC良好组患者Tp-e间期、Tp-e/QT比值低于CCC不良组,差异有统计学意义(P<0.05)。PCI治疗成功组与PCI治疗失败组患者术前临床资料及Tp-e间期、Tp-e/QT比值比较,差异有统计学意义(P<0.05)。PCI治疗成功组患者术后Tp-e间期、Tp-e/QT比值较术前下降,差异有统计学意义(P<0.05)。PCI治疗成功组患者术后Tp-e间期、Tp-e/QT比值低于PCI治疗失败组,差异有统计学意义(P<0.05)。结论CTO患者中,良好的侧支循环形成有利于降低心室跨壁复极离散度指标Tp-e间期、Tp-e/QT比值,更好地恢复CTO患者心肌细胞电生理稳定性;成功的PCI治疗可以减少CTO患者心室复极离散度指标Tp-e间期、Tp-e/QT比值,从而降低室性心律失常发生的风险。

Objectives To investigate the effect of coronary collateral circulation(CCC)and percutaneous coronary intervention(PCI)on the Tp-e interval and Tp-e/QT ratio in patients with chronic total coronary occlusion(CTO).Methods Totally 150 patients with CTO were selected from the Department of Cardiology of Shaoyang Central Hospital from July 2018 to December 2020.CCC used Rentrop score for classification,and the selected patients were divided into poor CCC group(Rentrop grade 0 group,grade 1 group)and good CCC group(Rentrop grade 2 group,grade 3 group).The Tp-e interval and Tp-e/QT ratio in the electrocardiogram(ECG)of each patient were caculated.In addition,the above subjects were divided into PCI success group and PCI failure group according to whether the PCI was successfully performed.The Tp-e interval and Tp-e/QT ratio of the ECG before and after PCI in the two groups were observed.Results The Tp-e interval and Tp-e/QT ratio in good CCC group were significantly lower than those in poor CCC group(P<0.05).In addition,there were no significant differences in clinical data,the Tp-e interval and Tp-e/QT ratio between successful PCI group and failure PCI group before the operation(P>0.05).The Tp-e interval and Tp-e/QT ratio decreased significantly after successful PCI(P<0.05).The postoperative Tp-e interval and Tp-e/QT ratio in successful PCI group were significantly lower than those in failure PCI group(P<0.05).Conclusions In patients with CTO,good collateral circulation is beneficial to reduce the ventricular transmural repolarization dispersion index Tp-e interval,Tp-e/QT ratio,and better restore the electrophysiological stability of cardiomyocytes.Successful PCI can reduce the ventricular repolarization dispersion index Tp-e interval and Tp-e/QT ratio in CTO patients,thereby reducing the risk of ventricular arrhythmia.