室性期前收缩负荷与心电图及心功能参数的相关性分析

doi:10.3969/j.issn.1006-7795.2015.03.012

首都医科大学学报 ›› 2015, Vol. 36 ›› Issue (3): 399-404.doi: 10.3969/j.issn.1006-7795.2015.03.012

• 心血管疾病的诊断与治疗 • 上一篇下一篇

室性期前收缩负荷与心电图及心功能参数的相关性分析

罗鸿宇¹, 华琦¹, 刘建峰², 朱玮玮¹

1. 首都医科大学宣武医院心脏科, 北京 100053;
2. 北京市利康医院内科, 北京 102609

收稿日期:2015-01-15 出版日期:2015-06-21 发布日期:2015-06-15
通讯作者: 华琦 E-mail:huaqi5371@medmail.com.cn
基金资助:
国家高技术研究发展计划(863计划)(2012AA02A516).

Discussion of the relationships between PVC-burden with electrocardiography and heart function parameters in patients with premature ventricular contractions

Luo Hongyu¹, Hua Qi¹, Liu Jianfeng², Zhu Weiwei¹

1. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Internal Medicine, Likang Hospital, Beijing 102609, China

Received:2015-01-15 Online:2015-06-21 Published:2015-06-15
Supported by:
This study was supported by Natural High Technology Research and Development Program of China(863 Program) (2012AA02A516)

摘要/Abstract

摘要：

目的探讨频发室性期前收缩(premature ventricular contractions,PVCs)患者期前收缩负荷、心电图QRS波时限、校正QT间期(correct QT interval by Bazett, QTCB)及心功能参数的关系.方法回顾性分析频发PVCs患者110例,根据期前收缩负荷分为低负荷组(< 10%,n=25)、中负荷组(10%~20%,n=54)、高负荷组(> 20%,n=31);另选取无PVCs患者34例为对照组,比较4组间基本资料、心电图指标、心功能参数等并分析其相关性.结果与对照组比较,中负荷组、高负荷组QRS波时限增宽、QTCB延长,高负荷组QT间期延长,中负荷组、高负荷组左心室心肌质量指数(left ventricular myocardial mass index, LVMI)升高,差异有统计学意义(P <0.05);经多元线性回归分析得出回归方程Y=0.047X₁+0.088 X₂-12.038,F=7.977,P=0.000,标准化回归系数QTCB为0.290,QRS波时限为0.193.结论随期前收缩负荷增加,QRS波时限增宽、QTCB延长、LVMI增加,且QTCB与期前收缩负荷的相关性大于QRS,应注意监测相关指标,早期予以临床干预.

关键词: 室性期前收缩, 期前收缩负荷, QRS波时限, 校正QT间期, 左心室心肌质量指数

Abstract:

Objective To study the relationships between premature ventricular contractions (PVCs) burden with the QRS duration, correct QT interval by Bazett (QTCB) on the ECG and heart function parameters in patients with frequent PVCs. Methods Retrospective analyzed 110 patients with frequent PVCs. All the patients were divided into 3 groups by the burden of PVCs: the lower burden group(< 10%,n=25), the medium burden group(10%-20%,n=54), the higher burden group(> 20%,n=31); and selected another 34 patients without PVCs as control group. The relationships between PVCs burden with electrocardiography and heart function were analyzed. Results Compared with the control group, the QRS duration, QTCB and left ventricular myocardial mass index (LVMI) were increased (P <0.01). The equation of liner regression is Y=0.047X₁+0.088 X₂-12.038,F=7.977,P=0.000,the standardized coefficients is QTCB=0.290, QRS duration=0.193.Conclusion The QRS duration, QTCB, and LVMI increased with PVCs burden's increase, and QTCB had a greater impact on PVCs burden.

Key words: premature ventricularcontractions, contraction burden, QRS duration, QTCB, left ventricular myocardial mass index

中图分类号:

R541.7

罗鸿宇, 华琦, 刘建峰, 朱玮玮. 室性期前收缩负荷与心电图及心功能参数的相关性分析[J]. 首都医科大学学报, 2015, 36(3): 399-404.

Luo Hongyu, Hua Qi, Liu Jianfeng, Zhu Weiwei. Discussion of the relationships between PVC-burden with electrocardiography and heart function parameters in patients with premature ventricular contractions[J]. Journal of Capital Medical University, 2015, 36(3): 399-404.

参考文献

[1] Ng G A. Treating patients with ventricular ectopic beats[J]. Heart, 2006, 92(11): 1707-1712.
[2] Bogun F, Crawford T, Reich S, et al. Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention[J]. Heart Rhythm, 2007, 4(7): 863-867.
[3] Yarlagadda R K, Iwai S, Stein K M, et al. Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract[J]. Circulation, 2005, 112(8): 1092-1097.
[4] Baman T S, Lange D C, Ilg K J, et al. Relationship between burden of premature ventricular complexes and left ventricular function[J]. Heart Rhythm, 2010, 7(7): 865-869.
[5] Yokokawa M, Kim H M, Good E, et al. Impact of QRS duration of frequent premature ventricular complexes on the development of cardiomyopathy[J]. Heart Rhythm, 2012, 9(9): 1460-1464.
[6] Sun Y, Blom N A, Yu Y, et al. The influence of premature ventricular contractions on left ventricular function in asymptomatic children without structural heart disease: an echocardiographic evaluation[J]. Int J Cardiovasc Imaging, 2003, 19(4): 295-299.
[7] Zipes D P, Camm A J, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death[J]. J Am Coll Cardiol,2006, 48(5): e247-346.
[8] Pacchia C F, Akoum N W, Wasmund S, et al. Atrial bigeminy results in decreased left ventricular function: an insight into the mechanism of PVC-induced cardiomyopathy[J]. Pacing Clin Electrophysiol, 2012, 35(10): 1232-1235.
[9] Smith M L, Hamdan M H, Wasmund S L, et al. High-frequency ventricular ectopy can increase sympathetic neural activity in humans[J]. Heart Rhythm, 2010, 7(4): 497-503.
[10] Pacchia C F, Akoum N W, Wasmund S, et al. Atrial bigeminy results in decreased left ventricular function: an insight into the mechanism of PVC-induced cardiomyopathy[J]. Pacing Clin Electrophysiol, 2012, 35(10): 1232-1235.
[11] Glatter K A, Myers R, Chiamvimonvat N. Recommendations regarding dietary intake and caffeine and alcohol consumption in patients with cardiac arrhythmias: what do you tell your patients to do or not to do? [J]. Curr Treat Options Cardiovasc Med, 2012, 14(5): 529-535.
[12] Huizar J F, Kaszala K, Potfay J, et al. Left ventricular systolic dysfunction induced by ventricular ectopy: a novel model for premature ventricular contraction-induced cardiomyopathy[J]. Circ Arrhythm Electrophysiol, 2011, 4(4): 543-549.
[13] Ban J E, Kim Y H. PVC-induced cardiomyopathy: the cut-off value for the premature ventricular complex burden[J]. Europace, 2013, 15(7): 1063-1064.
[14] Kunisek J, Zaputovic L, Mavric Z, et al. Influence of the type and degree of left ventricular hypertrophy on the prevalence of ventricular arrhythmias in patients with hypertensive heart disease[J]. Med Klin: Munich, 2008, 103(10): 705-711.
[15] Rekhraj S, Gandy S J, Szwejkowski B R, et al. High-dose allopurinol reduces left ventricular mass in patients with ischemic heart disease[J]. J Am Coll Cardiol, 2013, 61(9): 926-932.
[16] 潘文志. QRS波时限临床意义研究的进展[J]. 中国心脏起搏与心电生理杂志, 2007, 21(8): 448-451.
[17] Das M K, Cheriparambil K, Bedi A, et al. Prolonged QRS duration (QRS≥170 ms) and left axis deviation in the presence of left bundle branch block: A marker of poor left ventricular systolic function? [J]. Am Heart J, 2001, 142(5): 756-759.
[18] Dhingra R, Pencina M J, Wang T J, et al. Electrocardiographic QRS duration and the risk of congestive heart failure: the Framingham Heart Study[J]. Hypertension, 2006, 47(5): 861-867.
[19] Algra A, Tijssen J G, Roelandt J R, et al. QT interval variables from 24 hour electrocardiography and the two year risk of sudden death[J]. Br Heart J, 1993, 70(1): 43-48.
[20] 冯应君, 冯春, 陈郧. 冠心病室性心律失常患者的QT变异度[J]. 中国心血管杂志, 2001, 6(6): 341-343.
[21] 李琦, 王红宇, 赵明厚. 心肌梗死患者QT间期变异性和心率变异的分析[J]. 山西医药杂志, 2003, 32(6): 526-528.
[22] Dhingra R, Ho Nam B, Benjamin E J, et al. Cross-sectional relations of electrocardiographic QRS duration to left ventricular dimensions: the Framingham Heart Study[J]. J Am Coll Cardiol, 2005, 45(5): 685-689.
[23] Bogun F, Crawford T, Reich S, et al. Radiofrequency ablation of frequent, idiopathic premature ventricular complexes: comparison with a control group without intervention [J]. Heart Rhythm, 2007, 4(7): 863-867.
[24] 修明文,郭乐凌,何淼.STEMI冠状动脉介入后Tp-ec及QTc与恶性心律失常的相关性[J]. 临床误诊误治,2014,27(7):109-113.
[25] 全美燕,华琦,任海荣,等.不同负荷频发室性期前收缩患者血尿酸、QTCB、左室心肌质量指数比较分析[J]. 首都医科大学学报,2013,34(1):86-89.

室性期前收缩负荷与心电图及心功能参数的相关性分析

Discussion of the relationships between PVC-burden with electrocardiography and heart function parameters in patients with premature ventricular contractions

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