【摘要】 目的观察慢性心力衰竭患者心室再同步心脏转复除颤器(CRT-D)治疗前后T波峰末间期(Tpe)的变化及对室性心律失常的预测价值。方法 40例慢性心力衰竭患者行CRT-D治疗(CRT-D治疗组),观察术后1年患者的T波峰末间期、纽约心脏病协会(NYHA)心功能分级、左室射血分数(LVEF)、左室舒张末内径(LVEDD)及血浆氨基末端脑钠肽前体(NT-pro BNP)变化。根据术后1年内有无室性心动过速发生,分为室性心动过速组和无室性心动过速组,比较两者术后的T波峰末间期;另选取40例无慢性心力衰竭者作为对照组。结果慢性心力衰竭患者T波峰末间期较对照组延长,CRT-D治疗后较治疗前延长,差异均有统计学意义(P<0.05);CRT-D治疗组的患者中,发生室性心动过速的患者术后T波峰末间期较无室性心动过速组延长,差异有统计学意义(P<0.05),而两者的NYHA心功能分级、LVEF、LVEDD及血浆NT-pro BNP无显著变化(P>0.05)。结论慢性心衰患者经CRT-D治疗后T波峰末间期延长,且发生室性心动过速的患者延长更明显,T波峰末间期延长与CRT-D室性心律失常的发生率增加相关。更多还原

【Abstract】 Objective To investigate the variation of the Tpeak-Tend interval(Tpe) before and after cardiac resynchronization therapy defibrillator(CRT-D) treatment in patients with chronic heart failure, and to analyze its predictive value to ventricular arrhythmia. Methods Forty patients with heart failure undergoing CRT-D were selected as CRT-D treatment group. The Tpe was measured before and one year after receiving CRT-D, as well as the levels of serum N-terminal of the prohormone brain natriuretic peptide(NT-pro BNP), New York Heart Association(NYHA) functional classification, left ventricular ejection fraction(LVEF), left ventricular end-diastolic dimension(LVEDD). According to whether there was ventricular tachycardia within the one year after operation, the patients were divided into ventricular-tachycardia group and no-ventricular-tachycardia group, and the variation of Tpe was compared between the two groups. Moreover, 40 subjects without chronic heart failure were selected as the control group. Results Patients with chronic heart failure had increased Tpe compared to control group, and Tpe after CRT-D treatment was significantly longer than that before treatment(P<0.05). In CRT-D treatment group, compared with patients without ventricular tachycardia, the Tpe in patients with ventricular tachycardia increased significantly(P<0.05). There was no significant difference in serum NT-pro BNP levels, NYHA functional classification, LVEF and LVEDD between the two groups(P>0.05). Conclusion Patients with chronic heart failure have increased Tpe after CRT-D treatment. Increased Tpe is associated with increased incidence of ventricular arrhythmias in CRT-D.更多还原