急性冠脉综合征患者R波峰值时限与冠状动脉病变严重程度及近期预后的关系
Association of R wave peak time with severity of coronary artery disease and short-term prognosis in patients with acute coronary syndrome
陈俊斌 1孟文全 1易尚亨 1张乐2
作者信息
- 1. 深圳市龙华区中心医院功能科心电图室,广东 深圳 518110
- 2. 深圳市龙华区中心医院心血管内科,广东 深圳 518110
- 折叠
摘要
目的:探讨急性冠脉综合征(ACS)患者R波峰值时限(RWPT)与冠状动脉病变严重程度及近期预后的关系.方法:选择2019年1月至2022年6月期间深圳市龙华区中心医院收治、均行冠脉造影检查的ACS患者133例,根据冠脉病变支数分为单支病变组(43例)、双支病变组(51例)和多支病变组(39例);根据冠脉病变程度分为:轻度组40例,中度组48例,重度组45例.比较不同病变支数、病变程度组间心电图指标差异,采用Pear-son 相关分析心电图指标与 Gensini评分的相关性;根据住院期间是否发生主要不良心血管事件(MACE)分为MACE组(46例)和无MACE组(87例),比较两组临床资料,采用多因素Logistic回归分析ACS患者住院期间发生MACE的危险因素.结果:单支病变组、双支病变组、多支病变组QRS时限、RWPT均依次显著增加(P＜0.05或＜0.01);轻度组、中度组、重度组QRS时限、RWPT均依次显著增加(P＜0.05或＜0.01).Pearson相关分析显示,ACS患者QRS时限、RWPT与Gensini评分均呈正相关(r=0.222、0.557,P=0.010、＜0.001).多因素Logistic回归分析显示合并高血压病、糖尿病、RWPT、Gensini评分和多支病变是ACS患者住院治疗期间发生MACE的独立危险因素(OR=3.171～9.360,P＜0.05或＜0.01).结论:ACS患者RWPT与冠状动脉病变的严重程度密切相关,检测RWPT有利于指导ACS患者的危险分层和二级预防,从而改善患者的近期预后.
Abstract
Objective:To investigate the association of R wave peak time(RWPT)with severity of coronary artery disease and short-term prognosis in patients with acute coronary syndrome(ACS).Methods:A total of 133 ACS patients who were treated in Shenzhen Longhua District Central Hospital between January 2019 and June 2022 and received coronary angiography were selected.According to number of diseased coronary arteries,they were divided into single-vessel coronary disease group(n=43),double-vessel coronary disease group(n=51)and multi-vessel coronary disease group(n=39);according to severity of coronary artery disease,they were divided into mild group(n=40),medium group(n=48)and severe group(n=45).ECG indexes were compared among groups with different number of diseased coronary arteries and severity of coronary artery disease.Pearson correlation analysis was used to analyze corre-lation between ECG indexes and Gensini score;patients were divided into major adverse cardiovascular events(MACE)group(n=46)and no MACE group(n=87)according to presence of MACE during hospitalization.Clinical data were compared between two groups,and multivariate Logistic regression was used to analyze risk factors of MACE during hospi-talization in ACS patients.Results:QRS duration and RWPT significantly increased according to the order of single-ves-sel,double-vessel and multi-vessel coronary disease group(P＜0.05 or＜0.01);QRS duration and RWPT significantly increased according to the order of mild,medium and severe group(P＜0.05 or＜0.01).Pearson correlation analysis indi-cated that QRS duration and RWPT were significant positively correlated with Gensini score in ACS patients(r=0.222,0.557,P=0.010,＜0.001).Multivariate Logistic regression analysis indicated that hypertension,diabetes,RWPT,Gensini score and multi-vessel disease were independent risk factors for MACE during hospitalization in ACS patients(OR=3.171～9.360,P＜0.05 or＜0.01).Conclusion:RWPT is closely related to the severity of coronary artery disease in ACS patients.RWPT detection helps to guide risk stratification and secondary prevention of ACS patients,therefore im-prove their short-term prognosis.
关键词
急性冠状动脉综合征/心电描记术/冠状血管造影术Key words
Acute coronary syndrome/Electrocardiography/Coronary angiography引用本文复制引用
出版年
2024
NETL
NSTL
万方数据