肥厚型心肌病心电图QTe/RR与磁共振扫描心肌延迟增强相关性分析  

Correlation between ECG QTe/RR and MRI delayed myocardial enhancement in patients with hypertrophic cardiomyopathy

作　　者：陈源 黄姗 CHEN Yuan;HUANG Shan(Department of Function,First People′s Hospital of Qinzhou City,Qinzhou,Guangxi,535099,China)

机构地区：[1]钦州市第一人民医院功能科,广西钦州535099

出　　处：《心血管康复医学杂志》2020年第5期591-595,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究肥厚型心肌病(HCM)心电图QTe/RR与磁共振扫描心肌延迟增强的相关性。方法:选择在本院诊治的76例HCM患者为研究对象(HCM组),同时另选在本院体检健康志愿者76例为健康对照组,比较两组心脏超声、心电图等指标,采用3.0T磁共振扫描分析患者心肌延迟强化部位具体信息,采用Spearman秩相关系数法分析HCM心电图QTe/RR与磁共振扫描心肌延迟增强的相关性,采用COX回归分析影响HCM发生的危险因素。结果:与健康对照组比较,HCM组左室舒张末期内径(LVEDd)[(46.12±5.19)mm比(40.05±5.33)mm]显著减小,室间隔厚度(IVST)[(9.52±1.87)mm比(16.31±3.26)mm]和左心室射血分数(LVEF)[(52.62±8.14)%比(59.45±8.20)%]显著增加(P均=0.001);R波振幅增高(0%比98.68%)、T波倒置(0%比100%)、ST段压低发生率(1.32%比100%)及QT间期离散度(QTd)[(31.15±5.34)ms比(53.07±10.92)ms]水平均显著升高,QTe/RR斜率[(0.18±0.04)比(0.13±0.02)]显著减小(P均=0.001);Spearman秩相关分析显示HCM患者心电图QTe/RR与心肌延迟增强发生呈显著负相关(r=-0.785,P=0.003);多因素COX回归分析显示QTe/RR和心肌延迟增强是影响HCM发生的独立危险因素(HR=3.311、3.215,P均=0.001)。结论:HCM患者心室功能变化与心肌纤维化程度具有一定相关性,心电图QTe/RR和心肌延迟增强发生可用来预测HCM的发生发展。Objective:To study correlation between ECG QTe/RR and MRI delayed myocardial enhancement(DME)in patients with hypertrophic cardiomyopathy(HCM).Methods:A total of 76 HCM patients diagnosed and treated in our hospital were selected as HCM group,another 76 healthy volunteers undergoing physical examination in our hospital were regarded as healthy control group.Echocardiographic and ECG indexes were compared between two groups,3.0T MRI scanning was used to analyze specific information of DME sites.Spearman rank correlation method was used to analyze correlation between HCM ECG QTe/RR and MRI DME,COX regression analysis was used to analyze risk factors for HCM occurrence.Results:Compared with healthy control group,there was significant reduction in left ventricular end-diastolic dimension(LVEDd)[(46.12±5.19)mm vs.(40.05±5.33)mm],and significant rise in interventricular septal thickness(IVST)[(9.52±1.87)mm vs.(16.31±3.26)mm]and LVEF[(52.62±8.14)%vs.(59.45±8.20)%]in HCM group,P=0.001 all;significant rise in incidence rates of increased R wave amplitude(0%vs.98.68%),inverted T wave(0%vs.100%)and ST segment depression(1.32%vs.100%)and QT interval diversion(QTd)[(31.15±5.34)ms vs.(53.07±10.92)ms],and significant reduction in QTe/RR slope[(0.18±0.04)vs.(0.13±0.02)]in HCM group,P=0.001 all;in HCM patients,Spearman rank correlation indicated that ECG QTe/RR was significant inversely correlated with DME(r=-0.785,P=0.003);COX single factor analysis indicated that QTe/RR and DME were independent risk factors for HCM(HR=3.311,3.215,P=0.001 both).Conclusion:Ventricular function change possesses certain correlation with myocardial fibrosis degree in HCM patients.ECG QTe/RR and delayed myocardial enhancement can be used to predict occurrence and development of HCM.

关 键 词：心肌病 肥厚性 心电描记术 磁共振 

分 类 号：R542.2[医药卫生—心血管疾病]