论文部分内容阅读
目的探讨慢性心力衰竭(HF)患者QRS时限与组织多普勒显像(TDI)测定的收缩、舒张功能参数的相关关系。方法将104例心衰患者分为收缩性心衰(SHF,n=27)、舒张性心衰(DHF,n=49)、正常对照(n=28)3组。测量其心电图QRS时限,常规心脏超声测定EF、E/A、LVEDd、LVEDs。TDI测量二尖瓣环六位点Sm、Em,计算平均Sm、Em,评价心脏超声参数与QRS时限的相关关系。应用受试者工作特征曲线(ROC)评价平均Sm,预测QRS时限价值。结果3组QRS时限分别为106.1±24.1ms、92.6±10.7ms、96.7±15.9ms(p<0.01),QRS时限与EF、LVEDd、LVEDs、平均Sm的相关系数分别为-0.292(p<0.01)、0.364(p<0.001)、0.373(p<0.001)、-0.361(p<0.01);QRS时限与E/A、平均Em不相关;ROC分析显示平均Sm预测QRS时限≥120ms的曲线下面积为0.808(0.618-0.999,p<0.01),平均Sm界值为3.38m/s时预测QRS时限≥120ms的敏感度88.9%,特异度75.0%。结论HF患者中,SHF患者QRS时限大于DHF患者;QRS时限与收缩功能关系更为密切。
Objective To investigate the relationship between QRS duration and parameters of systolic and diastolic function measured by tissue Doppler imaging (TDI) in patients with chronic heart failure (HF). Methods 104 cases of heart failure were divided into three groups: systolic heart failure (SHF, n = 27), diastolic heart failure (DHF, n = 49) and normal control (n = 28). The ECG QRS time limit, conventional echocardiography EF, E / A, LVEDd, LVEDs. TDI measurement of mitral annular six-point Sm, Em, calculate the average Sm, Em, evaluation of echocardiographic parameters and QRS duration of the correlation. The receiver operating characteristic curve (ROC) was used to evaluate mean Sm and predict QRS duration value. Results The QRS durations of the three groups were 106.1 ± 24.1 ms, 92.6 ± 10.7 ms and 96.7 ± 15.9 ms respectively (p <0.01). The correlation coefficients of QRS duration with EF, LVEDd, LVEDs and mean Sm were -0.292 (p <0.01) , 0.364 (p <0.001), 0.373 (p <0.001), -0.361 (p <0.01). The QRS duration was not related to E / A and average Em. ROC analysis showed that the area under the curve of mean Sm prediction QRS duration ≥120ms was 0.808 (0.618-0.999, p <0.01). The sensitivity and specificity of QRS prediction ≥120 ms were 88.9% and 75.0% respectively when the average Sm cutoff was 3.38 m / s. Conclusion The duration of QRS in SHF patients is longer than that of DHF patients in HF patients. The QRS duration is more closely related to systolic function.