| QRS缩短值对心脏再同步化反应性的预测价值 |
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| 引用本文： | 余飞,李明明,马正科,姚亚丽. QRS缩短值对心脏再同步化反应性的预测价值[J]. 心脏杂志, 2021, 33(2): 160-164. DOI: 10.12125/j.chj.202009006 |
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| 作者姓名： | 余飞 李明明 马正科 姚亚丽 |
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| 作者单位： | 1.第一临床医学院，甘肃 兰州 730000 兰州大学 |
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| 摘 要： | 目的 探讨心脏再同步化治疗(CRT)患者术前与术后QRS间期的缩短值(△QRSd)对CRT有反应性的预测价值.方法 连续入选2012年2月至2019年9月我院心脏中心收住70例成功植入CRT的心力衰竭患者.根据患者CRT术后6个月左心室收缩末容积较术前改善≥15％,分为有反应组和无反应组,比较两组患者临床资料差异,采用...
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| 关 键 词： | 心力衰竭 心脏再同步化治疗 QRS缩短值 |
| 收稿时间： | 2020-09-02 |
The value of QRS shortening in predicting cardiac resynchronization reactivity |
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| Affiliation: | 1.The First Clinical Medical College, Lanzhou University, Lanzhou 730000, Gansu, China2.Heart Centre, The First Hospital of Lanzhou University, Lanzhou 730070, Gansu, China |
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| Abstract: | AIM To explore the predictive value of QRS interval shortening before and after cardiac resynchronization therapy in patients with (CRT) to CRT responsiveness. METHODS From February 2012 to September 2019, 70 patients with heart failure who were successfully implanted with CRT were admitted to the heart center of our hospital. According to the improvement of left ventricular end-systolic volume ≥ 15% six months after CRT compared with that before operation, the patients were divided into reactive group and non-responsive group. The difference of clinical data between the two groups was compared. Binary logistic regression was used to analyze the predictive value of QRSd responsiveness to CRT, and the best cutoff value for predicting CRT responsiveness was judged by the receiver's working characteristic curve (ROC). RESULTS Among the patients with chronic heart failure who were successfully implanted into CRT, there were 53 patients in response group and 17 patients in non-response group, and most of them were males. There were significant differences in left bundle branch block (LBBB) and left ventricular ejection fraction (△LVEF)、mitral regurgitation velocity (△MR)、△QRSd between the two groups before and after operation. Binary logistic regression analysis showed that △QRSd and△ LVEF were independent predictors of responsiveness in patients with CRT (OR=1.065, 95%CI: 1.012-1.122, P=0.017, OR=1.123, 95%CI: 1.010-1.248, P=0.032). The area under the ROC curve of QRS shortening value is 0.762(95%CI: 0.638-0.887), the maximum Jordan index is 0.402, the best cutoff point is 17 ms, the sensitivity is 0.755, and the specificity is 0.647. CONCLUSION The shortening of QRS has a certain predictive value for the responsiveness of patients with CRT. |
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