心力衰竭患者QRS波间期与心脏机械收缩功能失同步化的相关性研究  

Correlation between QRS duration and cardiac mechanical dyssynchrony in patients with congestive heart failure

作　　者：苗丽[1] 柳森[1] 周建军[1] 邓万俊[2] 

机构地区：[1]潍坊医学院附属文登中心医院心内科,264400 [2]南华大学附属南华医院心内科

出　　处：《中国心血管杂志》2010年第5期350-353,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的 评价充血性心力衰竭（CHF）患者QRS间期与左右心室间、左心室内不同步运动参数的相关关系.方法 81例CHF患者及26名健康体检者作为对照组纳入本研究.行常规及彩色组织多普勒显像（TDI）检查.以左、右心室间收缩延迟（IVMD）＞33 ms定义室间不同步运动,以二尖瓣环6位点中任意2点QRS波起始至心室收缩顶峰的间期（TsP）最长延迟＞121 ms,或6位点TsP的标准差（TsP-SD）＞47ms定义左心室内收缩不同步.比较QRS≥120 ms与QRS＜120 ms的CHF患者室间、室内不同步发生率,分析QRS间期与室间、室内不同步参数的相关关系.结果 CHF患者IVMD较对照组明显延长[（25.7±16.3）ms比（12.8±8.8）ms,P＜0.0001],IVMD与QRS间期呈明显正相关（r=0.44,P＜0.0001）.CHF伴QRS≥120 ms（n=31）者室间不同步发生率明显高于CHF伴QRS＜120 ms者（n=50）（66.7%比20.9%,P＜0.05）.CHF患者TsP最长延迟及TsP-SD较对照组明显延长,TsP最长延迟及TsP-SD与QRS间期呈弱相关.结论 CHF患者室间不同步运动发生率明显高于对照组,QRS间期增宽与室间不同步的关系可能更密切.Objective To assess the relationship between QRS duration and variables of interventricular and intraventrlcular mechanical dyssynchrony in patients with congestive heart failure （CHF）. Methods Eighty-one patients with CHF were recruited, and 26 healthy adults as control. Standard echocardiography and color-tissue Doppler imaging （C-TDI） were performed. Interventricular motion delay （ IVMD ） 〉 33 ms was defined as interventricular dyssynchrony. TsP-longest delay 〉 121 ms or TsP-SD 〉 47 ms was defined as intraventricular systolic dyssynchrony. Prevalences of interventricular and intraventricular mechanical dyssynchrony in CHF patients with QRS duration ≥120 ms and QRS duration 〈 120 ms were compared. Relationships between QRS duration and mechanical dyssynchrony were analyzed. Results IVMD was significantly longer in CHF group than in control group [ （25.7 ± 16. 3 ） ms vs. （ 12. 8 ± 8.8 ） ms, P 〈 0. 0001 ]. Significant positive correlation was found between IVMD and QRS duration （ r = 0.44, P 〈 O. 0001 ）. The prevalence of interventricular dyssynehrony in CHF patients with QRS duration ≥ 120 ms was higher than in CHF patients with QRS duration 〈 120 ms （66.7% vs. 20. 9% , P 〈0. 05）. The prevalence of interventricular dyssynchrony in CHF patients was significantly higher than in control group （33.3% vs. 3.8% , P 〈0. 01 ）. TsP-longest delay and TsP-SD were significantly longer in CHF group than in control group. Weak positive correlations were found between TsP-longest delay and TsP-SD with QRS duration. Conclusions The prevalence of interventricular mechanical dyssynchrony in CHF patients is significantly higher than in control group. QRS intervals are closely related to interventricular dyssynchrony.

关 键 词：心力衰竭 充血性 心电描记术 心脏病 

分 类 号：R541.6[医药卫生—心血管疾病]