Effect of reperfusion strategy on QT dispersion in patients with acute myocardial infarction:Impact on in-hospital arrhythmia

BACKGROUND Myocardial ischemia and ST-elevation myocardial infarction(STEMI)increase QT dispersion(QTD)and corrected QT dispersion(QTcD),and are also associated with ventricular arrhythmia.AIM To evaluate the effects of reperfusion strategy[primary percutaneous coronary intervention(PPCI)or fibrinolytic therapy]on QTD and QTcD in STEMI patients and assess the impact of the chosen strategy on the occurrence of in-hospital arrhythmia.METHODS This prospective,observational,multicenter study included 240 patients admitted with STEMI who were treated with either PPCI(group I)or fibrinolytic therapy(group II).QTD and QTcD were measured on admission and 24 hr after reperfusion,and patients were observed to detect in-hospital arrhythmia.RESULTS There were significant reductions in QTD and QTcD from admission to 24 hr in both group I and group II patients.QTD and QTcD were found to be shorter in group I patients at 24 hr than those in group II(53±19 msec vs 60±18 msec,P=0.005 and 60±21 msec vs 69+22 msec,P=0.003,respectively).The occurrence of in-hospital arrhythmia was significantly more frequent in group II than in group I(25 patients,20.8%vs 8 patients,6.7%,P=0.001).Furthermore,QTD and QTcD were higher in patients with in-hospital arrhythmia than those without(P=0.001 and P=0.02,respectively).CONCLUSION In STEMI patients,PPCI and fibrinolytic therapy effectively reduced QTD and QTcD,with a higher observed reduction using PPCI.PPCI was associated with a lower incidence of in-hospital arrhythmia than fibrinolytic therapy.In addition,QTD and QTcD were shorter in patients not experiencing in-hospital arrhythmia than those with arrhythmia.

Prolonged QT dispersion in inflammatory bowel disease

AIM:To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease(IBD).METHODS:This study included 63 ulcerative colitis(UC) and 41 Crohn's disease(CD) patients.Forty-seven healthy patients were included as the control group.Heart rate was calculated using electrocardiography,corrected QT dispersion(QTcd) and the Bazett's formula.Homeostasis model assessment(HOMA) was used to determine insulin resistance(IR).HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.RESULTS:Prolonged QTcd was found in 12.2% of UC patients,and in 14.5% of CD patients compared with the control group(P < 0.05).A significant difference was found between the insulin values(CD:10.95 ± 6.10 vs 6.44 ± 3.28,P < 0.05;UC:10.88 ± 7.19 vs 7.20 ± 4.54,P < 0.05) and HOMA(CD:2.56 ± 1.43 vs 1.42 ± 0.75,P < 0.05;UC:2.94 ± 1.88 vs 1.90 ± 1.09,P < 0.05) in UC and CD patients with and without prolonged QTcd.Disease behavior types were determined in CD patients with prolonged QTcd.Increased systolic arterial pressure(125 ± 13.81 vs 114.09 ± 8.73,P < 0.01) and age(48.67 ± 13.93 vs 39.57 ± 11.58,P < 0.05) in UC patients were significantly associated with prolonged QTcd.CONCLUSION:Our data show that IBD patients have prolonged QTcd in relation to controls.The routine followup of IBD patients should include determination of HOMA,insulin values and electrocardiogram examination.

Effect of transcatheter aortic valve implantation on QT dispersion in patients with aortic stenosis

BackgroundQT 分散(QTd ) 是室的心律不齐的一个预言者。室的心律不齐是与大动脉的狭窄在病人影响病态和死亡的一个重要因素。外科的大动脉的阀门代替在这个病人组减少了 QTd。然而， transcatheter 的效果在有大动脉的狭窄的病人的 QTd 上的大动脉的阀门培植(TAVI ) 是未知的。这研究的目的是调查 TAVI 的效果在上在有有严重大动脉的狭窄的大动脉的 stenosis.MethodsPatients 的病人，不由于禁止徵候或高外科的风险是外科的大动脉的阀门代替的候选人，的 QTd 在学习被包括。所有病人经历了 electrocardiographic 和 echocardiographic 评估在前，并且在 6 在 TAVI，计算 QTd 和左以后的 th 月室的集体索引(LVMI ).ResultsA 总数 30 病人进入学习(吝啬的年龄 83.2 ±；1.0 年，女性 21 和男性 9，吝啬的阀门区域 0.7 ±；3 公里 2) 。爱德华兹智慧心阀门， 23 公里(21 个病人) 和 26 公里(9 个病人) ，由 transfemoral，途径在 TAVI 过程被使用。所有 TAVI 过程是成功的。在 6 在 TAVI 以后的 th 月显著地在 TAVI 前与 QTd 和 LVMI 的基线价值相比被减少(73.8 ±；4 ms 对 68 ±；2 ms， P = 0.001 和 198 ±；51 g/m 2 对 184 ±；40 g/m 2, P = 0.04，分别地) 。在 QTd 和 LVMI 之间有重要关联(r = 0.646， P <；0.001 ).ConclusionsQTd，它诽谤室的心律不齐标记，和 LVMI 显著地在 TAVI 以后被减少过程。TAVI 可以减少在有大动脉的狭窄的病人的室的心律不齐的可能性。

QT Dispersion and QTc Interval in Patients with Adult Sickle Cell Disease: Electrocardiographic (EKG) and Echocardiographic Evaluation

Background: QT dispersion (QTd) varies according to heterogeneity of recovery time in the myocardium, and the impact of iron overload on the QTd in adult patients with Sickle Cell Disease (SCD) is not clear. Aim: This cross-sectional study was designed to evaluate corrected QTc interval and QTd on 12 leads ECG in patients with SCD, and assess the LV systolic and diastolic function using Pulsed Doppler Echocardiogram. Method: All patients were evaluated clinically with pulse Doppler echocardiography. Twelve leads ECG were taken to measure QTd and QTc. Blood samples withdrawn to assess the blood level of ferritin and hemoglobin. Pearson correlation coefficient was used to measure the linear relationship between serum ferritin and QTd. Results: The study included patients with SCD (n = 70, age 15.7 ± 8.9 years), compared with age-matched healthy control group (n = 70, age 15.9 ± 8.9 years). In patients with SCD compared with healthy control group the QTc (msec) 416 ± 23.21 ms vs. 401 ± 24.12 (p = 0.75), and the QTd were slightly longer in SCD compared with the control of 43 ± 22.1 vs. 38 ± 20.16 msec, (p = 0.071) with no significant difference. M mode echo showed that SCD patients compared with control had higher LVMI gm/M2 of 105 ± 10.3 vs. 83 ± 7.1, P = 0.001, larger LV end diastolic dimension (cm) of 5.5 ± 0.32 vs. 4.72 ± 0.35, p = 0.03, RV diameter (cm) of 2.8 ± 0.42 vs. 2.4 ± 0.31, (p = 0.041) and RV wall thickness (mm) of 0.31 ± 0.06 vs. 0.28 ± 0.03, (p = 0.024). Pulsed Doppler showed high LV transmitral E wave velocity of 85.23 ± 1.92 vs. 62.43 ± 1.67 m/s (p = 0.001), A wave (msec) 46.26 ± 4.7 vs. 56.24 ± 3.2 m/s, p = 0.032, with E/A ratio of 1.86 ± 0.01 vs. 1.10 ± 0.03, (p = 0.024) and DT of E wave (msec) of 156.43 ± 23.5 vs. 189.87 ± 19.5, (p = 0.031). Left ventricle ejection fraction percentage was similar between both groups, but SCD had significantly higher right ventricle tricuspid annular plane systolic excursion TAPSE (cm) of 1.23 ± 0.21 vs. 1.11 ± 0.23 cm (p = 0.02), and the tricuspid valve velocity showed significant higher velocity (m/s) in the SCD patients of 2.9 ± 0.14 vs. 1.7 ± 0.09, p = 0.004 indicating higher pulmonary artery pressure with calculated right ventricle systolic pressure of 38.64 vs. 16.56 mmHg. Conclusion: SCD patients compared with control have higher but not significant QT dispersion and corrected QT interval with a significantly larger LV mass and LV diastolic filling indices suggestive of restrictive diastolic pattern. These data indicate that LV diastolic abnormalities compromised initially in patients with SCD.

Defective recovery of QT dispersion following transcatheter aortic valve implantation： frequency, predictors and prognosis

BackgroundCorrected QT 分散(cQTD ) 与不一致的室的 repolarisation 被相关并且增加了死亡。在有大动脉的狭窄的病人， cQTD 被显示出在大动脉的阀门培植(TAVI ) 是的 transcatheter 的外科的阀门代替，而是效果以后改善了未知。因此，在 222 个病人全部的 TAVI.MethodsA 与在 2005 年 11 月和 2012 年 1 月之间的 Medtronic-CoreValve 系统经历了 TAVI 以后，我们寻求了在 6 个月探索频率，预言者和有缺点的 cQTD 恢复的预示的效果。或谁在一级或 III antiarrhythmics 上或在长期的血液透析上的病人发达 atrial 纤维性颤动，新捆分支块或在 TAVI 被排除以后，成为了依赖的心律调整器。作为结果， pre- ， up 以后和后续 ECG (中部：6 个月) 分析在 45 个合格病人是可得到的。有缺点的 cQTD 恢复在 6 months.ResultsIn 在基线 cQTD 以外被定义为任何前进 45 个病人，吝啬的 cQTD 是 47 &#x000b1；在基线的 23 ms， 45 &#x000b1；17 ms 立即在 TAVI 和 40 &#x000b1 以后；在 6 个月的 16 ms (15% 减小， P = 0.049 ) 。比作基线，而有缺点的 cQTD 恢复在 40% 是在场的，在 6 个月的 cQTD 在 60% 病人被改进。cQTD 增加立即在 TAVI 以后是在 6 个月的有缺点的 cQTD 恢复的一个独立预言者(每 10 ms 增加；或：1.89， 95% CI：1.15-3.12 ) 。由 univariable 分析，有缺点的 cQTD 恢复与迟了的死亡被联系(HR：1.52， 95% CI：1.05-2.17 ).ConclusionsDespite 在 TAVI 以后的 cQTD 的渐渐的减小， 40% 病人在与迟了的死亡被联系的 6 个月有有缺点的恢复。在 TAVI 以后的更多的详细 ECG 分析可以帮助避免迟了的死亡。

EFFECTS OF AMIODARONE AND SOME CLASS ⅠAGENTS ON QT DISPERSION

Objective To investigate the elfects of some class Ⅰ antiarrhythmic agents on QT dispersion and compared with those of amiodarone. Methods Group I was composed of 30 cases, they were all treated with class Ⅰ agents. The drugs used include: mexiletine (8 cases), moricizine (9), propafenone (12) and apridine (1). GrouP Ⅱ was composed of other 30 patients, and were all treated with amiodarone. The ddlerences of QT intervals between ECG leads (QTd and QTcd) were measured belore and aler medication. Results Before medication, the QTmax and QTcmax in group Ⅱ were signilicantly longer than those of group Ⅰ, resulting in greater QTd and QTcd in grouP Ⅱ (QTd:66± 14ms vs 31± 16ms, P<0.01; QTcd:71±36ms vs 44± 18ms, P<0.01). Alter medication, QTmax and QTcmax of group Ⅰ were prolonged, leading to the lengthening of QTd (from 31±16ms to 45±17ms, P<0.01) and QTcd (from 44± 18 ms to 58± 21ms, P<0.05), indicating the increase of inhomogeneity of myocardial repolarization after the treatment of class Ⅰ agents. Alter amiodarone treatment, QTmin and QTmax in grouP Ⅱ were both prolonged, with a greater amplitude of QTmin prolongation, resulting in decreased QTd and QTcd in group Ⅱ (QTd /rom 66± 14ms to 36±22ms, P<0.01, QTcd from 71±36ms to 45±27ms, P<0.01). The signifcant dofference of QTd and QTcd between two groups disappeared aler medication. Conclusion The results of the present study may relect the opposite effects of amiodarone and these class Ⅰ agents on myocardial repolarization.

QT interval dispersion in the patients with central serous chorioretinopathy

AIM: To evaluate QT dispersion(QTD) in patients with central serous chorioretinopathy(CSC).METHODS: This clinical, comperative, case-control study included 30 patients with CSC at acute phase(Group 1) and 30 age- and sex-matched healthy subjects(Group 2, the control group). From all subjects, a 12-lead surface electrocardiography was obtained. The heart rate(HR), QT maximum(QT max), QT minimum(QT min), QT corrected(QT c), QTD and T mean were manually measured and analyzed. Student’s t-test and Pearson’s method of correlation were used for statistical analysis.· RESULTS: The patient and control groups were matched for age, smoking status(rate and duration) and gender. There were no significant differences with regard to these among the groups(P 】0.05). The participants included 19 men(63.3%) and 11 women(36.7%) in Group1, 20 men(66.7%) and 10 women(33.3%) in Group 2.QT max, QTD and QT c were significantly higher than those of healthy controls(P 【0.001 for QT max, P =0.01 for QTD and P =0.001 for QT c). QT min, T mean and HR did not differ significantly between the study groups(P =0.28 for QT min,P =0.56 for T mean and P 】0.05 for HR). No significant correlation was found between duration of the disorder and QTD values(r =0.13, P 】0.05).CONCLUSION: These findings suggest that CSC may be associated with an increase in QTD and that the patients might be at risk for ventricular arrhythmia.

Effects of 6-minute walk test on the QT dispersion in patients with congestive heart failure

Objective: To investigate the clinical value of QT dispersion (QTd) and the effects of 6-minute walk test (6-MWT) mimicking the patients' daily activities on QTd in patients with congestive heart failure (CHF).Methods: Twenty-eight CHF patients and 22 normal subjects participated these study, who all completed 6-MWT without developing severe arrhythmias.Before and after 6-MWT, standardized 12-lead surface ECGs were obtained to measure QTd and corrected QTd (QTcd).Results: Both before and after 6-MWT, the QTd and QTcd in CHF patients were longer than those in the controls (P<0.001), and QTd and QTcd after 6-MWT were significantly shorter than those before 6-MWT in CHF patients (P=0.007, and 0.018).There was no significant difference in the measurement in the control group.Conclusion: QTd and QTcd are longer in CHF patients than in normal subjects.Moderate exercise may improve the inhomogeneity of ventricular repolarization dispersion in CHF patients.

QT Dispersion Level and Its Clinical Significance in Dilated Cardiomyopathy

Objective To evaluate the clinical significance of QT dispersion (QTd, QTcd) in dilated cardiomyopathy (DCM). Methods QTd and QTcd were measured on simultaneously recording 12 lead electrocardiograms (ECGs) in 60 DCM patients and compared with 60 healthy subjects. Results The values of QTd and QTcd in DCM were significantly higher than those in control group (P<0 01). With subgroup analysis, QTd and QTcd in patients with cardiac sudden death (CSD) were longer than those in survivors and those died of progressive heart failure (P<0 05), patients with ventricular tachycardia (VT) or with severe heart failure than those without (compared with patients with ventricular premature beats [VPB], P<0 05, compared with patients without ventricular arrhythmia [VA], P<0 01) or with mild heart failure (P<0 01). The values of QTd and QTcd in patients with VPB were greater than those in patients without VA(P<0 05). There were significant differences in the rates of VT, CSD and heart failure between the groups of QTd>110 ms and QTd≤110 ms(P<0 01 or P<0 05), in contrast to ejection fraction(EF) and fractional shortening (FS)(P>0 05). Conclusion The values of QTd and QTcd increased in DCM patients were susceptive index for monitoring maligant VA in DCM, also important prognostic markers of CSD. QTd was correlated with NYHA functional class but not with EF and FS.

活血化瘀汤辅助常规疗法治疗心肌梗死伴心房颤动的疗效及对QT校正离散度的影响

目的:探讨活血化瘀汤辅助常规疗法治疗心肌梗死(Myocardial infarction, MI)伴心房颤动(Atrial fibrillation, AF)的疗效及对QT校正离散度的影响。方法:前瞻性选取我院2020年8月—2023年3月收治的94例MI伴AF患者,按随机数表法分为观察组(n=47)、对照组(n=47)。对照组采用常规疗法治疗,观察组采用活血化瘀汤辅助常规疗法治疗。比较两组疗效,治疗前、治疗1个月后心功能指标(心排血量、左心室收缩末内径、舒张末内径、射血分数)、QT间期离散度[QT离散度(QTd)、校正的QT离散度(QTcd)]、炎症及氧化应激反应[超氧化物歧化酶(SOD)、NADPH氧化酶(NOX)、肿瘤坏死因子(TNF-α)]水平及不良反应发生情况。结果:观察组总有效率(95.74%,45/47)显著高于对照组(76.60%,36/47)(P<0.05);治疗1个月后观察组心排血量、左心室射血分数高于对照组,左心室收缩末内径、舒张末内径低于对照组(P<0.05);治疗1个月后观察组QTcd、QTd改善幅度大于对照组(P<0.05);治疗1个月后观察组SOD水平高于对照组,NOX、TNF-α水平均低于对照组(P<0.05);观察组不良反应总发生率为6.38%(3/47),与对照组的12.77%(6/47)相比,差异无统计学意义(P>0.05)。结论:采用活血化瘀汤辅助常规疗法治疗MI伴AF疗效显著,能有效抑制炎症、氧化应激反应,促进心功能、QT离散度改善,并能保障安全,利于预后病情转归。

fQRS、Tp-ec、QTd与急性心肌梗死PCI术后恶性心律失常发生的关系

目的：探讨急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入（PCI）治疗后碎裂QRS波（fQRS）、校正Tp-e间期（Tp-ec）、QT离散度（QTd）与恶性心律失常事件（MAE）发生的关系。方法：临床确诊的急性STEMI患者96例，12 h内成功施行PCI，随访1个月，发生MAE 24例，未发生MAE（NMAE）72例，分析其心电图指标和血生化指标。以60例正常人的心电图为对照。结果：MAE组fQRS阳性、Tp-ec≥100 ms、QTd≥70 ms的比例高于NMAE组（χ2＝6．192，5．714和6．128，P＜0．05）。急性STEMI患者PCI术前Tp-ec和QTd较对照延长（ t＝23．947，17．652，P＜0．05），术后两者逐渐恢复，但仍高于对照（P＜0．05）。术前和术后1周、1个月，MAE组Tp-ec、QTd均高于NMAE组（F组间＝32．675，33．476，P＜0．05）。 logistic回归分析显示，fQRS阳性（OR＝2．805，95％CI＝1．008～7．805）、Tp-ec≥100 ms（OR＝3．414，95％CI＝1．081～10．776）、QTd≥70 ms（OR＝2．979，95％CI＝1．058～8．386）是急性STEMI患者PCI术后MAE发生的危险因素。结论：fQRS、Tp-ec、QTd是急性STEMI患者PCI术后MAE发生的危险因素。

心得安试验QT离散度变化与QTd本质的研究

目的:研究心得安试验前后QT离散度(QTd)变化,探讨QTd的本质及评价其临床应用价值。方法:于经冠脉造影及其他检查除排除器质性心脏病,静息心电图有T波低平、双向、倒置或有u波的186例患者,观察心得安试验前、后QTd的变化。结果:(假定QTd>50ms为异常)78例心得安试验阳性者QTd异常率试验前、后分别为83.3％,11.5％,有显著差异(P<0.01);108例心得安试验阴性者QTd异常率试验前、后依次为77.8％,74.1％,无显著差异(P>0.05)。两组QTd异常率试验前无显著差异,试验后有显著差异(P<0.01)。结论:非器质性心脏病心得安试验QTd变化提示QTd异常不能作为反映心肌复极的不均一性指标,预测恶性心律失常或心脏猝死,而只是反映T波非特异性异常的一个粗浅的量化指标,对QTd的临床应用宜慎重。

珠海市社区老年人代谢综合征流行病学及其与心电图Pwd、QTd的关系研究

目的:探讨珠海市社区65岁以上老年人代谢综合征流行病学及其与心电图P波间期离散度(Pwd)、QT间期离散度(QTd)的关系。方法:选择珠海市湾仔社区65岁以上的本地居民为研究对象,登记居民的健康资料、体格检查以及生化项目实验室检查数据。同时记录标准12导联心电图,测量P波间期、Pwd、QT间期(QT)、QTd,计算校正的QT间期(QTc)、校正的QT间期离散度(QTcd),计算胰岛素抵抗指数(HOMA-IR)。结果:完成筛查的65岁以上老年居民385例,代谢综合征的患病率为30.13%。排除75例可能对心电图有影响的情况后,共310例纳入本研究。其中69例诊断为代谢综合征,纳入代谢综合征组(MS组),余下241例纳入非代谢综合征组(NMS组)。MS组在性别、高血压患病率、腹型肥胖比例、体质指数、血糖、空腹胰岛素、血脂、尿酸、超敏C反应蛋白、胰岛素抵抗、收缩压方面与NMS组相比有显著差异,两组在年龄、舒张压方面比较差异无统计学意义(P>0.05)。在心电图方面,MS组的心率、Pwd、QTc、QTd、QTcd明显高于NMS组(P<0.05或<0.001),而两组QT间期的比较无统计学差异(P>0.05)。结论:患代谢综合征的老年居民可表现出心电图Pwd、QTc、QTd、QTcd明显延长,需重视对这部分人群心电图的检测及心律失常的预防。

梗死前心绞痛对初次急性心肌梗死后QTd及严重室性心律失常的影响

目的 :观察 2 4h内心绞痛发作对初次急性心肌梗死 (AMI)患者住院期间严重室性心律失常及 QT离散度 (QTd)的影响。方法 :184例初次 AMI患者 ,分为梗死前心绞痛 (PA)组 ,5 8例 ;无梗死前心绞痛 (NPA)组 ,12 6例。观察住院期间心脏并发症及 QTd。结果 :两组间一般临床情况、冠心病危险因素、AMI前用药情况、AMI后抗心律失常药物使用、溶栓成功率及入院后肌酸磷酸激酶 (CK)及其 MB亚型 (CK- MB)峰值无显著差异。PA组及 NPA组早期 QTd分别为 (5 6 .2 2± 18.40 )及 (84.45±2 1.90 ) m s,(P<0 .0 5 ) ;晚期 QTd分别为 (5 0 .6 7± 16 .34 )及 (6 4.18± 16 .41) ms(P<0 .0 5 )。PA组严重室性心律失常、心力衰竭、心源性休克发生率及院内心源性病死率明显低于 NPA组。结论 :梗死前心绞痛显著降低 AMI患者住院期间 QTd值及严重室性心律失常的发生率。

索他洛尔对射频消融患者QTd的影响

目的 :观察索他洛尔对房室旁道射频消融 (RFCA )患者 QT离散度 (QTd)及电生理作用的影响 ,对药物在术中应用的安全性作评估。 方法 :36例房室折返性心动过速 (AVRT)接受 RFCA的患者 ,随机分为对照组 (18例 ,单纯行 RFCA)和药物组 (18例 ,RFCA+顿服索他洛尔 16 0 m g)。药物组服药后每 30 min测量 1次电生理参数 ,观察 2 .5 h。两组在术前、术后分别测量 QTd。 结果 :两组术前 QTd无差异 ,对照组术前、术后 QTd无明显变化。药物组服药后 ,电生理参数与服药前比较相差显著 ,RFCA术前、术后 QTd分别为 (30 .9± 14.3)和 (2 4.7± 9.6 ) m s;QTcd分别为 (33.7± 17.1)和 (2 5 .2± 10 .1) m s;QTL cd分别为 (30 .8± 14.1)和 (2 5 .6± 19.4) m s,3项参数均 P<0 .0 5。两组术后比较 QTd,QTcd,QTL cd均有显著差异。结论 :索他洛尔可轻度降低 QTd,致心律失常的危险性较低 ,无器质性病变的 RFCA患者术中应用可帮助终止心动过速频繁发作 。

参松养心胶囊治疗心力衰竭合并室性心律失常患者的效果及对QTd和血浆NT-proBNP水平

目的:探讨参松养心胶囊配合西药治疗心力衰竭合并室性心律失常患者的临床效果、对血浆N氨基末端脑钠肽前体(NT-pro BNP)及心电图QT离散度(QTd)的影响。方法:选取2014年1月至2016年4月我院心内科诊治的96例心力衰竭合并室性心律失常患者,根据就诊号分为中西医组、西医组各48例,2组患者均给予胺碘酮治疗,中西医组服用参松养心胶囊,2组患者连续治疗2个月,对比临床效果。结果:治疗后,中西医组的动态心电图心跳次数、早搏次数、血浆NTpro BNP及心电图QTd均低于西医组,差异有统计学意义(P<0.05),中西医组的室性早搏Lown氏分级优于西医组,差异有统计学意义(P<0.05);治疗后,中西医组的愈显率64.58%高于西医组43.75%,差异有统计学意义(P<0.05)。结论:参松养心胶囊配合西药治疗心力衰竭合并室性心律失常效果优于单用西药,能更显著的降低血浆NT-pro BNP及心电图QTd水平。

Tp-Te间期和QTd在预测冠心病恶性心律失常中的价值研究

目的评价Tp-Te间期、QTd、QTcd及其组合在预测冠心病恶性心律失常中的价值。方法入选158例确诊冠心病患者,入院时全部予以12导联心电图检查,将患者按照是否发生恶性心律失常(室性心动过速、心室扑动、心室纤颤)分为病例组和对照组,比较两组患者Tp-Te、QTd、QTcd值,计算它们及其组合在预测恶性心律失常中的敏感度、特异性等指标。结果病例组Tp-Te、QTd、QTcd均大于对照组(P<0.01)。Tp-Te在预测恶性心律失常中的价值最高,其次为QTcd,其敏感度、特异性、阳性预测值、阴性预测值分别为88.46%vs 84.62%、92.5%vs 77.5%、92.0%vs 78.6%、89.2%vs 83.8%。Tp-Te与QTcd并、串联未能提高对恶性心律失常的预测能力。结论 与QTd、QTcd相比,Tp-Te是预测冠心病恶性心律失常强有力的指标,尤其当Tp-Te间期>148ms时应积极预防。