PCI和CABG术对高龄慢性冠脉闭塞病变患者QT、QTc和JT离散度的影响及与心功能的相关性

目的对高龄冠心病患者行经皮冠状动脉介入治疗（PCI）和冠状动脉搭桥术（CABG）术前、后的QT间期离散度（QTd）、校正QT间期离散度（QTcd）、JT间期离散度（JTd）的变化及与心功能相关性的研究。方法利用标准同步12导联心电图和二维彩色多普勒超声心动图对51例行PCI和CABG手术前后的高龄冠心病患者的QTd、QTcd和JTd离散度和心功能进行检测。结果高龄冠脉闭塞患者PCI与CABG术后的QTd、QTcd及JTd较手术前均显著缩短（P<0.01）,高龄冠脉闭塞患者PCI与CABG术后的心功能指数（LVEF,E）明显增加（P<0.01）。高龄冠脉闭塞患者PCI与CABG术后的QTd及JTd的显著缩短与LVEF的增加呈正相关。结论对于高龄患者严重狭窄或完全闭塞的冠状动脉由于尚有存活心肌,再通后部分存活心肌可恢复电、机械功能,这对挽救这些存活心肌具有重要意义。

Effects of coronary arterial intervention and coronary arterial bypass grafting on QT, QTc, JT interval dispersion and correlation with left ventricular function in elderly patients with coronary artery disease

AIM To evaluate effects of percutaneous coronary intervention (PCI) and coronary arterial bypass grafting (CABG) on QT, QTc, JT interval dispersion and correlation with left ventricular function in elderly patients with coronary artery disease. METHODS Using electrocardiogram of 12 leads and echocardiography, changes of QT, QTc, JT interval dispersion and left ventricular function in 51 elderly patients with coronary artery disease were observed and evaluated before and after PCI and CABG. RESULTS After PCI and CABG, QTd, QTcd and JTd minished markedly ( P<0.01), while LVEF,E of left ventricular function were increased ( P<0.01) in elderly patients with coronary artery disease. At the same time, QTd, QTcd, JTd had positive correlation with LVEF,E of left ventricular function after PCI and CABG. CONCLUSION PCI and CABG can minish QTd, QTcd, JTd and increase LVEF,E of left ventricular function in elderly patients with coronary artery disease. Therefore revascularization can rescue viable cardiomyocytes and resume myocardial electrical and mechanical activities in elderly patients with coronary artery disease.