MTWA技术联合血清miR-130a对心脏再同步化治疗后CHF患者室性心律失常的预测价值  

Predictive value of MTWA technology combined with serum miR-130a for ventricular arrhythmia in patients with chronic heart failure after cardiac resynchronization therapy.

作　　者：李培培[1] 邵莹莹 王莉[2] 陈利红[3] LI Pei-pei;SHAO Ying-ying;WANG Li;CHEN Li-hong(Department of Cardiography,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Physical Examination,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院心电图室,河南郑州450000 [2]郑州大学第一附属医院心内科,河南郑州450000 [3]郑州大学第一附属医院体检科,河南郑州450000

出　　处：《海南医学》2024年第23期3345-3349,共5页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20230247)。

摘　　要：目的探讨微伏级T波电交替(MTWA)技术联合血清微小RNA-130a(miR-130a)对心脏再同步化治疗(CRT)后慢性心力衰竭(CHF)患者室性心律失常的预测价值。方法前瞻性选取2021年3月至2022年1月郑州大学第一附属医院收治的130例经CRT治疗的CHF患者,均于CRT前、CRT 6个月后进行MTWA检查和血清miR-130a检测。所有患者均随访12个月,失访7例,根据随访期间是否发生室性心律失常分为发生组26例和未发生组97例,比较两组患者CRT前和CRT 6个月后的MTWA参数、血清miR-130a水平;采用Spearman相关系数法分析MTWA参数、血清miR-130a与CHF患者室性心律失常的相关性;采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析MTWA、血清miR-130a预测CHF患者室性心律失常的价值。结果CRT前、CRT 6个月后发生组V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA、miR-130a均高于未发生组,差异均有统计学意义(P<0.05);Spearman相关系数法分析结果显示,CRT前、CRT 6个月后V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA及miR-130a均与CHF患者室性心律失常发生呈正相关(P<0.05);ROC曲线分析结果显示,CRT前、CRT 6个月后V1导联MTWA_(max)、V1导联8:00 am MTWA、V5导联MTWA_(max)、V5导联8:00 am MTWA及血清miR-130a联合预测的AUC分别为0.912、0.933(P<0.05)。结论MTWA参数、血清miR-130a与CHF患者室性心律失常存在一定线性关系,CRT治疗前后MTWA参数和血清miR-130a联合预测CHF患者发生室性心律失常具有一定的价值。Objective To investigate the predictive value of microvolt T-wave alternans(MTWA)technology combined with serum microRNA-130a(miR-130a)for ventricular arrhythmias in patients with chronic heart failure(CHF)after cardiac resynchronization therapy(CRT).Methods A prospective study was conducted on 130 patients with CHF who were treated with CRT at the First Affiliated Hospital of Zhengzhou University from March 2021 to January 2022.All patients underwent MTWA examination and serum miR-130a detection before and after 6 months of CRT.All patients were followed up for 12 months.According to whether ventricular arrhythmia occurred during the follow-up period,the patients were divided into the occurrence group(26 cases)and the non-occurrence group(97 cases).The MTWA parameters and serum miR-130a levels were compared between the two groups before and after CRT for 6 months.Spearman correlation coefficient method was used to analyze the correlation between the MTWA parameters,serum miR-130a,and ventricular arrhythmia in patients with CHF.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the value of MTWA and serum miR-130a in predicting ventricular arrhythmia in patients with CHF.Results The MTWA_(max) of V1 lead,MTWA of V1 lead at 8:00 am,MTWA_(max) of V5 lead,MTWA of V5 lead at 8:00 am,and miR-130a in the occurrence group before CRT and after 6 months of CRT were significantly higher than those the non-occurrence group(P<0.05).Spearman correlation coefficient analysis showed that before CRT and after 6 months of CRT,MTWA_(max) of V1 lead,MTWA of V1 lead at 8:00 am,MTWA_(max) of V5 lead,MTWA of V5 lead at 8:00 am,and miR-130a were positively correlated with the occurrence of ventricular arrhythmia in CHF patients(P<0.05).ROC curve analysis showed that the AUC of MTWA_(max) of V1 lead,MTWA of V1 lead at 8:00 am,MTWA_(max) of V5 lead,MTWA of V5 lead at 8:00 am,and serum miR-130a in combination before CRT and after 6 months of CRT were 0.912 and 0.933,respectively(P<0.05).Conclusio

关 键 词：慢性心力衰竭 微伏级T波电交替 微小RNA-130a 心脏再同步化治疗 室性心律失常 预测价值 

分 类 号：R541.7[医药卫生—心血管疾病]