慢性心功能不全及心律失常与心电图V1导联P波终末电势的相关性

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目的探讨心电图V1导联P波终末电势(P-terminal force,Ptf V1)与慢性心力衰竭(CHF)及心律失常的关系。方法选择2014年1-12月在天津市第三中心医院分院心内科住院的CHF患者83例为CHF组,年龄(72.3±5.3)岁,其中男性40例,女性43例,依据美国纽约心脏病学会(NYHA)心功能Ⅰ、Ⅱ、Ⅲ、Ⅳ分级标准,将CHF患者分为4个亚组。选择同期50例健康体检者[(70.5±5.2)岁]为对照组,两组均常规行12导联心电图检查计算Ptf V1值,并进行对比分析和CHF组Ptf V1值与心功能分级相关性检验。两组病例行24 h动态心电图检查,对心律失常情况和Ptf V1值进行相关分析,计算CHF组各亚组的心律失常发生率。结果 CHF组的Ptf V1值[(0.047±0.018)mm·s]明显高于对照组[(0.007±0.006)mm·s],差异有统计学意义(P<0.05);CHF组各亚组间比较(其中Ⅰ组和Ⅱ组Ptf V1比较虽有所增加,但差异无显著性),Ptf V1值随着心功能分级的增加而明显升高,差异有统计学意义(F=32.732,P<0.05)。Ptf V1值与心功能分级呈正相关(r=0.732,P<0.01)。随着心功能分级的增加,心律失常率[包括房性早搏、室性早搏、阵发房扑、阵发房颤、交界区早搏和(或)房室传导阻滞]有逐渐增加的趋势,差异有统计学意义(P<0.01)。Ptf V1值越大,心率失常发生率越高(r=0.422,P<0.05)。结论 CHF及心律失常与Ptf V1值具有相关性,其可以作为评价CHF患者心功能水平的可靠指标,并对临床预测CHF患者发生心律失常具有一定的预测价值。 Objective To investigate the relationship between P-terminal force (Ptf V1) and chronic heart failure (CHF) and arrhythmia in V1 lead of ECG. METHODS: From January to December 2014, 83 CHF patients hospitalized in Department of Cardiology, Third Central Hospital of Tianjin, CHF, aged 72.3 ± 5.3 years, 40 males and 43 females, (NYHA) cardiac function Ⅰ, Ⅱ, Ⅲ, Ⅳ grading standards, the CHF patients were divided into 4 subgroups. Fifty healthy subjects [(70.5 ± 5.2) years] of the same period were selected as the control group. The Ptf V1 values ​​of 12-lead electrocardiogram were routinely calculated in both groups, and the correlation between Ptf V1 value and cardiac function grade was analyzed test. Two groups of patients underwent 24 h dynamic electrocardiogram examination, arrhythmia and Ptf V1 values ​​were analyzed, the incidence of arrhythmia in each subgroup CHF group was calculated. Results The Ptf V1 value in CHF group was significantly higher than that in control group [(0.047 ± 0.018) mm · s) [(0.007 ± 0.006) mm · s) (P <0.05) (Group Ⅰ and group Ⅱ Ptf V1 comparison, although there was no significant difference, Ptf V1 value increased with the increase of cardiac function was significantly higher, the difference was statistically significant (F = 32.732, P < 0.05). There was a positive correlation between Ptf V1 and heart function (r = 0.732, P <0.01). Arrhythmia rates (including atrial premature beats, premature ventricular contractions, paroxysmal atrial flutter, paroxysmal atrial fibrillation, borderline premature beats and / or atrioventricular block) tended to increase with an increase in cardiac function, The difference was statistically significant (P <0.01). The larger the Ptf V1 value, the higher the rate of arrhythmia (r = 0.422, P <0.05). Conclusions CHF and arrhythmia are correlated with Ptf V1 value, which can be used as a reliable index to evaluate the cardiac function of patients with CHF, and have certain predictive value for the clinical prediction of cardiac arrhythmia in CHF patients.
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