慢性心力衰竭病人QRS综合波幅值及形态的变化

探讨慢性心力衰竭 (CHF)病人QRS综合波幅值及形态的变化与意义。使用常规、高频及动态心电图分别采集 6 0例不同病因CHF病人QRS综合波幅度、QRS切迹与扭挫、室性心律失常等体表心电信息。结果 :QRS幅度的缺血性心脏病 (IHD)与扩张型心肌病 (DCM)较对照组 (1.76± 0 .2 7,1.5 7± 0 .14vs 2 .2 3± 0 .32mV ,P均 <0 .0 5 )降低。IHD、高血压性心脏病 (HHD)与DCM的QRS切迹数的较对照组 (5 .43± 0 .2 5 ,4.36± 0 .19,7.2 3± 0 .46vs 0 .6 4± 0 .11mV)增多 ;各组室性异位搏动显著增加。上述改变随CHF加重愈趋明显。结论 :由QRS综合波幅值及形态变化所反映的心脏电活动异常 ,可能是导致CHF病人心律失常的电生理基础

Changes of Amplitude and Modality of QRS Complex in Patients with Chronic Heart Failure

To investigate changes and significance of both amplitude and modality of QRS complex in patients with chronic heart failure(CHF),the amplitude and modality of QRS complex in patients with ischemic heart disease(IHD, n=22 ),hypertensive heart disease(HHD, n=20 )and dilated cardiomyopathy(DCM, n=18 )were measured by means of 12 lead ECG,24 hour ECG(Holter)and high frequency ECG.Results:Compared with control( n=20 ,2.23±0.32 mV),QRS amplitude of patients with IHD(1.76±0.27mV, P<0.05 )and DCM(1.57±0.14 mV, P<0.05 )were reduced.Notching of QRS in patients with IHD(5.43±0.25 mV, P<0.05 ),HHD(4.36±0.19 mV, P<0.05 )and DCM(7.23±0.46 mV, P<0.05 )were increased while that of subjects in control was 0.64±0.11 mV.Ventricular arrhythmia in patients with different heart diseases were also increased.The above changes were more remarkable when CHF was getting more severe.Conclusion:Abnormallites of cardiac electrophysiology indicated by changes of both amplitude and modality of QRS complex may be an electrophysioloical basis of arrhythmias for patients with CHF.