老年慢性心力衰竭患者左室应变参数、QRS波时限变化及其与MACE发生的关系  

Changes in left ventricular strain parameters and QRS wave duration in elderly patients with heart failure and their relationship with the occurrence of MACE

作　　者：贾亚婧 李爽 李翔华 JIA Yajing;LI Shuang;LI Xianghua(Department of Cardiovascular Medicine,Sinopharm Tongmei General Hospital,Datong,Shanxi 037003,China;Department of Ultrasound,Sinopharm Tongmei General Hospital,Datong,Shanxi 037003,China)

机构地区：[1]国药同煤总医院心血管内科,山西大同037003 [2]国药同煤总医院超声科,山西大同037003

出　　处：《检验医学与临床》2024年第17期2584-2587,共4页Laboratory Medicine and Clinic

摘　　要：目的分析左室应变参数、QRS波时限与老年慢性心力衰竭患者发生主要不良心血管事件(MACE)的关系。方法选取2022年1月至2023年1月该院收治的300例老年慢性心力衰竭患者为研究对象,以是否发生MACE分为MACE组和非MACE组。比较两组基线资料、左室应变相关参数、QRS波时限和振幅。采用多因素Logistic回归分析老年慢性心力衰竭患者MACE发生的独立影响因素。采用受试者工作特征(ROC)曲线分析各项指标对老年慢性心力衰竭患者MACE发生的预测效能。结果经过6个月随访,57例老年慢性心力衰竭患者发生MACE,纳入MACE组,其余未发生MACE患者纳入非MACE组。两组性别、年龄、吸烟史、饮酒史、纽约心脏协会心功能分级、糖尿病、高血压方面比较,差异均无统计学意义(P>0.05),两组舒张压、收缩压比较,差异均有统计学意义(P<0.05)。MACE组左室长轴收缩期纵向峰值应变(LS)、左室峰值收缩总应变(GLS)、峰值应变离散度(PSD)高于非MACE组,差异均有统计学意义(P<0.05)。MACE组QRS波时限大于非MACE组,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,GLS、PSD、QRS波时限是老年慢性心力衰竭患者MACE发生的独立影响因素(P<0.05)。ROC曲线分析结果显示,GLS、PSD、QRS波时限预测老年慢性心力衰竭患者MACE发生的曲线下面积分别为0.812、0.736、0.886。结论左室应变参数GLS、PSD及QRS波时限可以反映老年慢性心力衰竭患者左室同步性和心功能变化,是老年慢性心力衰竭患者发生MACE的独立影响因素,对其MACE发生有较好的预测价值。Objective To analyze the relationship between left ventricular strain parameters,QRS wave duration and major adverse cardiovascular events(MACE)in elderly patients with chronic heart failure.Methods A total of 300 elderly patients with chronic heart failure admitted to Sinopharm Tongmei General Hospital from January 2022 to January 2023 were selected as the research subjects.They were divided into MACE group and non MACE group based on whether MACE occurred.The baseline data,left ventricular strain related parameters,QRS wave duration and amplitude in the two groups were compared.Multivariate Logistic regression was used to analysis the independent influencing factors for the occurrence of MACE in elderly patients with chronic heart failure.The receiver operating characteristic(ROC)curve was used to analyze the prognosis value of each indexes for MACE in elderly patients with chronic heart failure.Results After 6 months of follow-up,57 elderly patients with chronic heart failure developed MACE and were included in the MACE group,while the remaining patients without MACE were included in the non MACE group.There was no statistically significant difference in terms of gender,age,smoking history,drinking history,New York Heart Association cardiac function classification,diabetes and hypertension between the two groups(P>0.05),but there was statistically significant difference in diastolic blood pressure and systolic blood pressure between the two groups(P<0.05).The left ventricular long axis longitudinal peak strain(LS),global longitudinal peak systolic strain(GLS),peak strain discrete(PSD)in the MACE group were higher than those in the non MACE group,and the differences were statistically significant(P<0.05).The QRS wave duration in the MACE group was longer than that in the non MACE group,and the difference was statistically significant(P<0.05).The results of multivariate Logistic regression analysis showed that GLS,PSD and QRS wave duration were independent influencing factors for the occurrence of MACE in elderl

关 键 词：心力衰竭 老年 左室应变参数 主要不良心血管事件 QRS波时限 预后 

分 类 号：R444[医药卫生—诊断学] R541.6[医药卫生—临床医学]