|本期目录/Table of Contents|

[1]王玉占,刘娟.心电图参数预测心脏再同步治疗患者发生超反应的意义[J].医学研究与战创伤救治(原医学研究生学报),2017,19(01):62-66.[doi:10.3969/j.issn.1672-271X.2017.01.017]
　WANG Yu-zhan,LIU Juan.Electrocardiographic parameters predict super-response in cardiac resynchronization therapy[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(01):62-66.[doi:10.3969/j.issn.1672-271X.2017.01.017]
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心电图参数预测心脏再同步治疗患者发生超反应的意义()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年01期
页码:
62-66
栏目:
出版日期:
2017-01-20

文章信息/Info

Title:
Electrocardiographic parameters predict super-response in cardiac resynchronization therapy
作者:
王玉占; 刘娟
作者单位：053000衡水，哈励逊国际和平医院临床电生理科
Author(s):
WANG Yu-zhan;  LIU Juan
(Department of Clinical Electrophysiology, Ha Li Xun International Peace Hospital, Hengshui 053000，Hebei, China)
关键词:
心脏再同步治疗(CRT); 心电图; 超反应
Keywords:
Cardiac resynchronization therapy (CRT);  Electrocardiographic;  Super-response
分类号:
R541.6
DOI:
10.3969/j.issn.1672-271X.2017.01.017
文献标志码:
A
摘要:
目的 探讨12导联心电图（ECG）参数预测心脏再同步治疗患者发生超反应的意义。方法 采用ECG记录心脏再同步治疗（CRT）设备植入前基线水平及植入后即刻心电活动，分析基线ECG参数（QRS波时限、束支形态、电轴、PQ间期、QT间期）及植入后起搏QRS时限，并计算QRS时限的相对变化。超反应定义为12个月后左室舒张末期容积降低≥30%。结果 本组101例患者，32例（31.7%）出现超反应。超反应组与非超反应组之间ECG基线水平差异无统计学意义，但超反应组起搏QRS时限短于非超反应组[（148±22）ms vs (162±28)ms; P=0.010]。CRT植入后超反应组出现QRS波显著降低。超反应组出现相对QRS波缩短的比例显著高于非超反应组[12.1%（6.8～22.2) vs 1.7%（-11.9～11.8）; P=0.005]。采用多变量分析得出，NYHAⅡ级、起搏QRS时限及相对QRS波缩短是预测CRT患者发生超反应的因素。结论 起搏QRS时限及相对QRS波缩短是与CRT患者发生超反应相关的参数。
Abstract:
Objective The aim of the study was to assess the value of ECG parameters to predict super-response in CRT patients.Methods A 12-lead surface ECG was recorded at baseline and immediately after CRT-device implantation. Baseline ECG parameters (QRS duration, bundle branch morphology, axis, PR interval, QTc) and post-implant paced QRS duration were analyzed; relative change in QRS duration was calculated. Decrease of left ventricular end-systolic volume ≥30% after 12 months was classified as super-response.Results In group of 101 patients, 32 (31.7%) were super-responders. There were no significant differences in baseline ECG parameters between super-responders and other patients. Post-implant QRS duration was shorter in super-responders [(148±22) ms vs （162±28) ms; P=0.010). Only in super-responders was significant QRS reduction observed after implantation. Relative QRS shortening was higher in super-responders [12.1% (6.8 to 22.2) vs 1.7% (-11.9 to 11.8); P=0.005]. In a multivariable analysis NYHA, post-implant QRS duration and relative QRS shortening remained independent predictor of super-response.Conclusion Post-implant QRS duration and relative QRS shortening are the only ECG parameters associated with super-response in CRT

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2017-01-20