Guo Hui, Wang Miao, Zhao Juan, Liu Jing, Yang Jie-Mei
Department of Cardiology, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
Department of Cardiology Ultrasound, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
J Geriatr Cardiol. 2018 Jan;15(1):41-49. doi: 10.11909/j.issn.1671-5411.2018.01.010.
Chronic heart failure (CHF) is life-threatening without timely or effective intervention. In this study, we investigated the association between QT dispersion corrected for heart rate (cQTd) and heart function in patients with CHF.
From January 2013 to December 2015, we continuously enrolled 240 patients categorized as New York Heart Association functional class (NYHA) III-IV with a left ventricular ejection fraction (LVEF) < 40%. Based on the etiology, the patients were divided into a dilated cardiomyopathy (DCM) group ( = 120) and an ischemic cardiomyopathy (ICM) group ( = 120). Then, based on the cQTd width, the ICM group was divided into two subgroups: a QS group (cQTd ≤ 60 ms, = 70) and a QL group (cQTd > 60 ms, = 50). All patients were examined by echocardiography and 12-lead electrocardiography (ECG) at 1, 3, 6, and 12 months after enrollment.
After one year of optimized medical treatment, patients in both groups showed significant improvement in LVEF and NYHA classification from baseline. However, the cQTd in the ICM group, especially the QL, was significantly shorter than that in the DCM group at each time point. In addition, the cQTd was negatively correlated with LVEF and 6-min walking test and positively correlated with NYHA class in the ICM group.
The present findings clearly demonstrate that cQTd is a meaningful parameter for assessing heart function in the follow-up of ICM patients.
慢性心力衰竭（CHF）若不及时或有效干预会危及生命。在本研究中，我们调查了心率校正QT离散度（cQTd）与CHF患者心功能之间的关联。
2013年1月至2015年12月，我们连续纳入240例纽约心脏协会功能分级（NYHA）为III-IV级且左心室射血分数（LVEF）<40%的患者。根据病因，将患者分为扩张型心肌病（DCM）组（n = 120）和缺血性心肌病（ICM）组（n = 120）。然后，根据cQTd宽度，将ICM组分为两个亚组：QS组（cQTd≤60 ms，n = 70）和QL组（cQTd>60 ms，n = 50）。所有患者在入组后1、3、6和12个月接受超声心动图和12导联心电图（ECG）检查。
经过一年的优化药物治疗，两组患者的LVEF和NYHA分级较基线均有显著改善。然而，ICM组，尤其是QL组，在每个时间点的cQTd均显著短于DCM组。此外，ICM组中cQTd与LVEF和6分钟步行试验呈负相关，与NYHA分级呈正相关。
目前的研究结果清楚地表明，cQTd是评估ICM患者随访中心功能的一个有意义的参数。
