PtfV_1在心衰患者的应用价值

The clinical value of P wave terminal force in lead V_1 for the patients with heart failure

目的探讨V1导联P波终末电势(P wave terminal force in lead V1,PtfV1)在心功能不全患者中的临床应用价值。方法 110例心功能不全患者及100例正常对照组纳入研究。测量、计算、记录所有入选者的体表心电图PtfV1数值,超声心动图左室射血分数(LVEF)以及性别、年龄、民族等相关临床指标。按照纽约心功能分级(NYHA)将病例组分为轻症组(NYHAⅠ~Ⅱ)及重症组(NYHAⅢ~Ⅳ)。按照LEVF下降程度将病历组分为LEVF轻度下降组(LVEF 40%~50%)及中重度下降组LVEF<40%。分别比较心功能不全患者与正常人,NYHA分级严重程度不同的患者之间相较,LEVF下降程度不同的患者之间相较,PtfV1数值的差异。并分析PtfV1与传统评价心功能严重程度的指标LVEF之间的相关性。结果 1心功能不全患者与对照组相较,PtfV1数值明显下降(p<0.05);2NYHA分级重症心功能不全患者较轻症患者的PtfV1数值明显下降(p<0.05);3LVEF中重度降低患者与轻度降低的患者相较,Ptfv1数值明显下降(p<0.05);4PtfV1与LVEF呈显著正相关,相关系数r=0.77,p<0.01。结论 V1导联P波终末电势(PtfV1)可作为评价心功能不全患者病情严重程度的一项临床心电学指标。

Objective To research the clinical value of P wave terminal force in lead V1( PtfV1) for the patients with heart failure. Methods 110 cases of heart failure patients and 100 healthy subjects enrolled in the study.Recording the PtfV1, LVEF, sex, age, nationality,etc of all the subjects. According to the New York Heart Association classification of cardiac function(NYHA), the patients were divided into mild Group(NYHAⅠ- Ⅱ) and severe Groups(NYHA Ⅲ- Ⅳ). According to the decreased level of LVEF, the patients were divided into Slightly- decreasedlevel- group and Moderate- to- severe- decreased- level- group. Compared the differences of PtfV1 were found between the Groups, and then to analysis the correlation between PtfV1 and LVEF. Results 1 PtfV1 were obviously decreased in heart failure patients(p<0.05); 2 PtfV1 in Severe Group patients were significantly decreased than Mild Group(p<0.05); 3 PtfV1 in patients of LVEF Moderate- to- severe- decreased- level- group were obviously decreased than patients of LVEF Slightly- decreased- level- group. 4 PtfV1 and LVEF was significantly positively correlated, r=0.77,p<0.01. Conclusions PtfV1 is a clinical electrocardiology index to evaluate the severity of patients with heart failure.