碎裂QRS波预警左心室收缩功能障碍患者心脏事件和死亡风险队列研究  

A cohort study on fragmented QRS as a predictor of prognosis of mortality and cardiac events in patients with left ventricular systolic dysfunction

作　　者：杜建霖[1] 邓松柏[1] 赵睿[1] 王喜春[1] 何莉[1] 向玉鸾[1] 佘强[1] 

机构地区：[1]重庆医科大学附属第二医院心血管内科,重庆400010

出　　处：《临床心血管病杂志》2010年第4期298-302,共5页Journal of Clinical Cardiology

摘　　要：目的:评价碎裂QRS波(Fragmented QRS complexes,fQRSs)对左心室收缩功能障碍(LVSD)患者心脏事件和死亡率的影响。方法:504例LVSD病例入选,常规ECG检测,分为f QRSs组和非f QRSs组2组;随访比较2组患者全因死亡率和心脏事件发生率。结果:随访(32·8±13·8)个月,f QRSs组全因死亡率[54例(34·62%)∶83例(23·85%),P=0·012]和心脏事件[97例(62·18%)∶151例(43·39%)]的发生率明显高于非f QRSs组(P<0·001)。Kaplan-Meier生存分析提示f QRSs组无心脏事件生存率明显降低(P<0·001),生存率降低(P=0·012);多变量Cox回归分析揭示f QRSs是LVSD患者心脏事件和全因死亡率的独立预警指标。结论:f QRSs是LVSD患者心脏事件和全因死亡率独立预警的指标,f QRSs与无心脏事件生存率和生存率降低有关。Objective：To determine whether fragmented QRS （fQRSs） can predict cardiac events and mortality in patients with left ventricular systolic dysfunction.Methods：The cardiac events and all-cause mortality were retrospectively reviewed in 504 patients with LVSD who were divided into two groups：fQRSs group and non-fQRSs group by ECG test. Results：All-cause mortality （54 [34.62%] vs 83 [23.85%],P=0.012） and cardiac event rate （97 [62.18%] vs 151 [43.39%],P〈0.001）were higher in the fQRSs group compared with the non-fQRSs group during a mean follow-up of 32.8±13.8 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events （P〈0.001）and all-cause mortality （P=0.012）.Multivariate Cox regression analysis revealed that fQRSs was an independent significant predictor for cardiac events and all-cause mortality.Conclusion：The fQRS is an independent predictor for cardiac events and all-cause mortality in patients with LVSD. It is associated with significantly lower event-free survival for a cardiac event and all-cause mortality on long-term follow-up.

关 键 词：碎裂QRS波 心脏性猝死 死亡率 心脏事件 左心室收缩功能障碍 

分 类 号：R541[医药卫生—心血管疾病]