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PCI和CABG术对高龄慢性冠脉闭塞病变患者QT、QTc和JT离散度的影响及与心功能的相关性(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第1期
页码:
65-66，71
栏目:
临床研究
出版日期:
2006-01-01

文章信息/Info

Title:
Effects of coronary arterial intervention and coronary arterial bypass grafting on QT, QTc, JT interval dispersion and correlation with left ventricular function in elderly patients with coronary artery disease
作者:
崔华1; 范利1;  朱平2;  盖鲁粤3; 李小鹰2; 高长青4
解放军总医院：1.南二科，2.南六科，3.心内科，4.心外科，北京 100853
Author(s):
CUI Hua1;  FAN Li1;  ZHU Ping2;  GAI Lu-yue3;  LI Xiao-ying2;  GAO Chang-qing4
1.Second Department of Southern Building，2.Sixth Department of Southern Building，3.Department of Cardiology，4.Department of Cardiological Surgery,General Hospital of PLA,Beijing 100853,China
关键词:
冠状动脉疾病; 高龄; 血运重建; QT离散度; 冠状动脉介入治疗; 经皮; 冠状动脉搭桥术
Keywords:
coronary artery disease;  elderly patients;  QT dispersion;  coronary intervention; percutaneous;  coronary artery bypass grafting
分类号:
R540.45
DOI:
-
文献标识码:
A
摘要:
目的 对高龄冠心病患者行经皮冠状动脉介入治疗 （PCI）和冠状动脉搭桥术(CABG)术前、后的QT间期离散度（QTd）、校正QT间期离散度（QTcd）、JT间期离散度（JTd）的变化及与心功能相关性的研究。方法 利用标准同步12导联心电图和二维彩色多普勒超声心动图对51例行PCI和CABG手术前后的高龄冠心病患者的QTd、QTcd和JTd离散度和心功能进行检测。结果 高龄冠脉闭塞患者PCI与CABG术后的QTd、QTcd及JTd较手术前均显著缩短（P<0.01）， 高龄冠脉闭塞患者PCI与CABG术后的心功能指数 （LVEF，E）明显增加（P<0.01）。高龄冠脉闭塞患者PCI与CABG术后的QTd及JTd的显著缩短与LVEF的增加呈正相关。结论 对于高龄患者严重狭窄或完全闭塞的冠状动脉由于尚有存活心肌，再通后部分存活心肌可恢复电、机械功能，这对挽救这些存活心肌具有重要意义。
Abstract:
AIM To evaluate effects of percutaneous coronary intervention (PCI) and coronary arterial bypass grafting (CABG) on QT, QTc, JT interval dispersion and correlation with left ventricular function in elderly patients with coronary artery disease. METHODS Using electrocardiogram of 12 leads and echocardiography, changes of QT, QTc, JT interval dispersion and left ventricular function in 51 elderly patients with coronary artery disease were observed and evaluated before and after PCI and CABG. RESULTS After PCI and CABG, QTd, QTcd and JTd minished markedly ( P<0.01), while LVEF，E of left ventricular function were increased ( P<0.01) in elderly patients with coronary artery disease. At the same time, QTd, QTcd, JTd had positive correlation with LVEF，E of left ventricular function after PCI and CABG. CONCLUSION PCI and CABG can minish QTd, QTcd, JTd and increase LVEF，E of left ventricular function in elderly patients with coronary artery disease. Therefore revascularization can rescue viable cardiomyocytes and resume myocardial electrical and mechanical activities in elderly patients with coronary artery disease.

参考文献/References

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［2］ 贾三庆,惠永明,李田昌,等. 急性心肌梗死后相关血管再灌注对校正ＱＴ离散度的影响［J］. 中华心血管病杂志,1998,26:374-376.

［3］ Zabel M, Klingenheben T, Franz MR, et al. Assesment of QT dispersion for prediction of mortality or arrhythmic events after myocardia infarction: result of a prospective, longterm followup study ［J］. Circulation, 1998,97:2543-2550.

［4］鲁端. 心肌M细胞的电生理特性和临床意义［A］. 郭继鸿. 新概念心电图［M］. 北京:北京医科大学出版社,1999.4-8.

［5］ Dagianti A, Rosanio S, Penco M. et al. Clinical and prognostic usefulness of supine bicycle exercise echocardiography in the functional evaluation of patients undergoing elective percutaneous transluminal coronary angioplasty ［J］. Circulation, 1997,95(5): 1176-1184.

备注/Memo

备注/Memo:
收稿日期：2004-12-24.作者简介：崔华，副主任医师,博士Tel:(010)66939553 66939543 Email:bjcuihua@yahoo.com.cn
更新日期/Last Update: