The Relationship between QRS Duration,Left Ventricular Ejection Fraction and Cardiac Function in Elderly Patients with Heart Failure and Its Predictive Value for Cardiac Function Deterioration
Objective:To investigate the relationship between QRS duration(QTcd),left ventricular ejection fraction(LVEF)and cardiac function in elderly patients with heart failure and its predictive value for the deterioration of cardiac function.Methods:150 elderly patients with heart failure treated in our hospital from January 2018 to January 2022 were selected as the research object,and all patients were grouped by NYHA classification,including 26 cases of grade I,37 cases of grade Ⅱ,54 cases of grade Ⅲ and 33 cases of grade Ⅳ.All patients were diagnosed by ECG and echocardiography.The levels of qrsd and LVEF in the four groups were compared,and the cor-relation between qrsd,LVEF and cardiac function in elderly patients with heart failure was analyzed by Spearman correlation analysis.All patients were followed up for 12 months after discharge.Patients with acute myocardial infarction and death and patients with NYHA grade higher than 1 compared with that before treatment were divided into cardiac function deterioration group(n=50),and the remaining patients were divided into non cardiac function deterioration group(n=100).The clinical general conditions and the expression of qrsd and LVEF in the two subgroups were compared,and the logistic regression analysis was used to analyze the expression of qrsd,LVEF The predictive value of LVEF on the deterioration of cardiac function in elderly patients with heart failure.Results:There were differ-ences in the expression of qrsd and LVEF in elderly patients with heart failure of different functional grades.The level of qrsd in patients with grade Ⅳ was higher than that in patients with grade Ⅲ,Ⅱ and Ⅰ,and the level of LVEF in patients with grade Ⅳ was lower than that in patients with grade Ⅲ,Ⅱ and Ⅰ(P＜0.05);Spearman correlation analysis showed that qrsd was positively correlated with the de-gree of cardiac function(P＜0.05),while LVEF was negatively correlated with the degree of HBV cardiac function(P＜0.05);There were no differences in gender,age,body mass index(BMI),diabetes mellitus,hypertension,left ventricular end diastolic dimension(LVEDd)between the deterioration group and the non deterioration group(P＞0.05)The levels of QT interval(qrsd),QTcd,amino terminal A-type natriuretic peptide(NT proANP),C-reactive protein(CPP),left ventricular mass index(LVMI)and LVEF were different(P＜0.05);Logis-tic regression analysis showed that NYHA classification,combined with old myocardial infarction,qrsd,QTcd,NT proANP,CPP,LVMI and LVEF were independent predictors of cardiac function deterioration in elderly patients with heart failure(P＜0.05).Conclusion:Qrsd and LVEF are significantly correlated with cardiac function in elderly patients with heart failure,and the increase of qrsd and the decrease of LVEF may predict the deterioration of cardiac function in patients with heart failure,so the treatment scheme for elderly patients with heart failure with increased qrsd and decreased LVEF can be adjusted in time to prevent the deterioration of cardiac function.
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