扩张型心肌病患者碎裂QRS波与预后的关系

陈刚; 黄婷; 杨锴

doi:10.13201/j.issn.1001-1439.2014.11.018

扩张型心肌病患者碎裂QRS波与预后的关系

- 武汉市中心医院心血管内科(武汉, 430014)

详细信息

通讯作者: 陈刚,E-mail:chengangwuhan@126.com

中图分类号: R542.2

收稿日期: 2014-01-14

Relationship between fragmented QRS and prognosis in patients with dilated cardiomyopathy

- Department of Cardiology, The Central Hospital of Wuhan, Wuhan, 430014, China

More Information

Corresponding author: CHEN Gang, E-mail: chengangwuhan@126.com

Received Date: 14 January 2014

摘要

摘要: 目的:评价在扩张型心肌病患者中碎裂QRS波(fragmented QRS,fQRS)与预后的关系。方法:纳入扩张型心肌病患者178例,按是否伴有碎裂QRS波分为fQRS组(62例)和正常组(116例),进行随访,比较两组终点事件(因心力衰竭再次入院和心源性死亡)发生率,通过Cox多元回归分析fQRS与终点事件的关系。结果:与正常组相比,fQRS组患者的QT间期较长[(387.8±25.6)ms : (375.7±30.2)ms,P<0.01],左室射血分数(LVEF)较低[(29.2±6.3)% : (35.6±7.5)%,P<0.01],左室舒张末期内径较大[(70.2±3.5)mm : (68.4±4.8)mm,P=0.01],N末端B型脑钠肽前体(NT-proBNP)浓度较高[(3644±178) pg/dl : (3270±213) pg/dl,P<0.01]和NYHA分级较高(Ⅱ/Ⅲ/Ⅳ:12/23/37:32/68/16,P<0.01];平均随访(15.2±3.4)个月,fQRS组终点事件发生率显著高于正常组(72.5%∶42.2%,P<0.01);Cox多元回归分析表明fQRS、LVDD、LVEF和NT-proBNP是患者终点事件发生的独立危险因素。结论:fQRS与扩张型心肌病患者的预后密切相关,是患者预后的重要危险因素。
- 扩张型心肌病 /
- 碎裂QRS波 /
- 心力衰竭 /
- 心源性死亡
Abstract: Objective:To assess the relationship between fragmented QRS(fQRS) and prognosis in patients with dilated cardiomyopathy(DCM). Method:A total of 178 patients with DCM were divided into fQRS group (n=62) and control group (n=116), then difference in combined end-events (re-hospital for heart failure and cardiac-caused mortality) was compared between two groups in follow-up period, and the relation between fragmented QRS(fQRS) and prognosis was estimated using Cox proportional-hazards models. Result:Compared to the control group, the fQRS group showed longer QT duration[(387.8±25.6)ms vs (375.7±30.2)ms,P<0.01], reduced LVEF [(29.2±6.3)% vs (35.6±7.5)%,P<0.01], greater LVDD[(70.2±3.5)mm vs (68.4±4.8)mm,P=0.01], higher NT-proBNP level[(3644±178) pg/dl vs (3270±213) pg/dl,P<0.01] and higher NYHA grade(Ⅱ/Ⅲ/Ⅳ:12/23/37 vs 32/68/16,P<0.01). Average follow-up to (15.2±3.4) months, the incidence of combined end-events was significant higher in the fQRS group than the control group((72.5% vs 42.2%,P<0.01), and the results of Cox proportional-hazards models displayed that fQRS, LVDD, LVEF and NT-proBNP were independent risk factors of prognosis in patient with DCM. Conclusion: There is a close relationship between fragmented QRS and prognosis in DCM patients, and the fragmented QRS was a critical risk factor of prognosis for these patient populations.
- dilated cardiomyopathy /
- fragmented QRS /
- heart failure /
- cardiac death

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