| 摘要: |
| 目的：探讨碎裂QRS波(fragmented QRS complexes,fQRS)与心功能接近正常的冠心病患者心室同步性的关系。方法：176例窄QRS波、左室射血分数接近正常(≥50％)的冠心病患者(68±9岁,男性145名,女性31名),根据心电图有无fQRS分为fQRS阳性组和fQRS阴性组。采用组织多普勒技术测量左室各节段收缩速度,速度达峰时间,并计算12节段速度达峰时间最大差值(Ts-12)及标准差(Ts-SD),以Ts-SD≥32.6ms作为存在左室内不同步标准。结果：55例(31％)患者伴随fQRS。与阴性组比较fQRS阳性组Ts-12,Ts-SD明显延长(Ts-12 128.8ms±49.6ms vs. 110.6ms±46.3ms, P=0.019; Ts-SD 43.7ms±17.7ms vs. 37.8ms±17.4ms, P=0.04)。且fQRS阳性组发生左室收缩不同步比例明显高于阴性组(75%vs. 58%,P=0.033)。多因素回归统计分析显示：fQRS与左室不同步指数Ts-SD(OR：1.06；95%CI： 1.01-1.11,P=0.016)和多支冠脉病变相关(OR：2.85：95%CI：1.27-6.41,P=0.011)。 |
| 关键词: 碎裂QRS波 冠状动脉疾病 同步性 组织多普勒 |
| DOI： |
| 投稿时间：2016-06-18修订日期：2017-01-07 |
| 基金项目:国家自然科学基金青年科学(81401418) |
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| The Relationship between Fragmented QRS and Intraventricular Systolic Dyssynchrony in CAD Patients with a Narrow QRS Interval |
| YAN Guohui |
| () |
| Abstract: |
| ABSTRACT Objective The purpose of this study was to investigate the relationship between fragmented QRS(fQRS) and intraventricular dyssynchrony in patients with CAD. Methods 176patients with CAD were recruited. The fQRS included various RSR’patterns without typical bundle branch block on a 12-lead ECG in 2 contiguous leads corresponding to a major coronary artery territory. Intraventricular dyssynchrony was evaluated with Tissue Doppler imaging echocardiography. Results There was 55 (31%) patients in present fQRS (fQRS group) and 121(69%) patients in absent fQRS(non-fQRS group). Indices of intraventricular dyssynchrony including Ts-12 (128.8ms±49.6ms vs. 110.6ms±46.3ms, P=0.019) and Ts-SD (43.7ms±17.7ms vs. 37.8ms±17.4ms, P=0.04) were significantly prolonged in fQRS group compared to non-fQRS group. In addition, the proportion of LV dyssynchrony was significantly higher in patients with fQRS compared to those without fQRS (75%vs. 58%, P=0.033). Multivariate analysis revealed that Ts-SD (Odd ratio[OR]1.06, 95%confidence interval[CI]1.01-1.11, P=0.016) and multivessel lesion (OR 2.85, 95%CI：1.27-6.41，P=0.011 ) were independent predictors for fQRS. Conclusion Fragmentation of QRS complexes on ECG are associated with intraventricular systolic dyssynchrony in patients with CAD, suggesting that depolarization abnormality may contribute to intraventricular dyssynchrony.
[Keywords] Fragmented QRS；Coronary artery disease；Synchrony；Tissue Doppler |
| Key words: Fragmented QRS Coronary artery disease Synchrony Tissue Doppler |
