QRS时限与心力衰竭患者利钠肽及心脏超声参数的相关性研究

Study of correlation of QRS duration with natriuretic peptide and cardiac ultrasound parameters in patients with heart failure

目的:研究心电图QRS时限(QRSd)与心力衰竭(心衰)患者心功能部分评价指标的相关性。方法:收集2018年6月-2020年2月复旦大学附属金山医院心血管内科收治的住院心衰患者324例的临床资料,根据QRSd分为四组:QRSd<110 ms组、110 ms≤QRSd<130 ms组、130 ms≤QRSd<150 ms组和QRSd≥150 ms组,比较四组间心功能评价指标利钠肽(BNP)、心脏超声参数的差异。结果:年龄在四组间有明显差异,且变化与QRSd较弱呈正相关(r=0.142,P=0.005),BNP与QRSd呈正相关(r=0.167,P=0.001)。心衰患者中左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左房内径(LAD)与QRSd呈正相关(r=0.403,P<0.001;r=0.413,P<0.001;r=0.154,P=0.003)。多重线性回归显示LVEDD对QRSd的影响最大(β=0.273),其次为LVESD(β=0.18),左室射血分数(LVEF)、左心室短轴缩短率(FS)与QRSd呈负相关(r=-0.499,P<0.001;r=-0.328,P=0.018)。结论:心衰患者随着QRSd延长,心功能越差。

Objective:To study correlation between QRS duration of electrocardiogram(QRSd)and partial evaluation indexes of cardiac function in patients with heart failure(HF).Methods:Clinical data of 324 hospitalized patients with heart failure from June 2018 to February 2020 in the Department of Cardiology of Jinshan Hospital affiliated to Fudan University were collected,and according to QRSd,divided into four groups:QRSd<110 ms group,110 ms≤QRSd<130 ms group,130 ms≤QRSd<150 ms group,and QRSd≥150 ms group,and the differences of cardiac function evaluation indexes,such as natriuretic peptide(BNP)and cardiac ultrasound parameters among the four groups were compared.Results:There was a significant difference in age among the four groups,and there was a weak positive correlation between the changes and QRSd(r=0.142,P=0.005);BNP was positively correlated with QRSd(r=0.167,P=0.001),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)and left atrial diameter(LAD)were positively correlated with QRSd in patients with heart failure(r=0.403,P<0.001;r=0.413,P<0.001;r=0.154,P=0.003).Multiple linear regression showed that LVEDD had the greatest impact on QRSd(β=0.273),followed by LVESD(β=0.18),left ventricular ejection fraction(LVEF)and left ventricular short axis shortening rate(FS)were negatively correlated with QRSd(r=-0.499,P<0.001;r=-0.328,P=0.018).Conclusion:With the prolongation of QRSd,the cardiac function of patients with heart failure became worse.