急性心肌梗死患者心电图QT离散度与直接经皮冠状动脉介入治疗反应之间关系的评估。
Evaluation of the Relationship between QT Dispersion in ECG and Response to Primary PCI in Patients with Acute Myocardial Infarction.
作者信息
Ghods Hosseini Mir Mohammad Sadra, Dodangeh Samira, Javadi Hamid Reza, Razaghi Alireza, Haji Karimi Majid
机构信息
Clinical Research Development Unit, Qods Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
Clinical Research Development Unit, Booalisina Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
出版信息
Med J Islam Repub Iran. 2024 Aug 27;38:98. doi: 10.47176/mjiri.38.98. eCollection 2024.
BACKGROUND
St-elevation myocardial infarction (STEMI) is a serious condition that occurs when the blood flow to one or more coronary arteries is blocked, leading to damage or death of the heart muscle (myocardial injury or necrosis). The present study aimed to compare QTc and QTd intervals in patients with STEMI before and 90 minutes after treatment in Booali Sina Hospital, Qazvin, Iran.
METHODS
The present study is an analytical cross-sectional study. Between March 2021 and 2022, 107 patients administered to Booali Sina Hospital, Qazvin, Iran, due to STEMI who underwent primary PCI were enrolled in the study. Data including age, sex, height and weight, disease history, QTc interval before and 90 minutes after treatment, QTd before and 90 minutes after treatment and Ejection fraction values were extracted from the patient's files. Then, the relationship between change in QT and QTd after treatment with response to treatment based on ST Resolution was evaluated. SPSS 20.0 statistical program was used for the statistical analysis. All values are given as mean± standard deviation (SD). A p-value of less than 0.05 was considered as significant.
RESULTS
The observed mean difference in investigated variables of patients, including age, height, weight, and BMI, was not statistically significant between the two groups (response to treatment and non-response to treatment ( > 0.05). Findings demonstrated that the mean QTd 1 in the response to the treatment group was higher compared to the non-response to the treatment group, and this difference was not statistically significant ( = 0.337). It is remarkable that the mean QTd 2 in the response to treatment group was statistically significantly lower than the non-response to treatment group ( = 0.002).
CONCLUSION
We showed that QTd in the studied patients after primary angioplasty reduced significantly compared to the QTd before the treatment, so the QTd can be considered as a noninvasive measure of the response to the treatment in patients with STEMI.
背景
ST段抬高型心肌梗死（STEMI）是一种严重病症，当一条或多条冠状动脉血流受阻时就会发生，导致心肌损伤或死亡（心肌损伤或坏死）。本研究旨在比较伊朗加兹温市布阿利·西纳医院STEMI患者治疗前和治疗90分钟后的QTc和QTd间期。
方法
本研究为分析性横断面研究。2021年3月至2022年期间，107例因STEMI入住伊朗加兹温市布阿利·西纳医院并接受直接经皮冠状动脉介入治疗（PCI）的患者纳入研究。从患者病历中提取年龄、性别、身高、体重、病史、治疗前和治疗90分钟后的QTc间期、治疗前和治疗90分钟后的QTd间期以及射血分数值等数据。然后，根据ST段回落情况评估治疗后QT和QTd变化与治疗反应之间的关系。采用SPSS 20.0统计软件进行统计分析。所有数值均以均值±标准差（SD）表示。p值小于0.05被认为具有统计学意义。
结果
两组患者（治疗反应组和无治疗反应组）在年龄、身高、体重和BMI等研究变量上观察到的平均差异无统计学意义（>0.05）。结果表明，治疗反应组的平均QTd 1高于无治疗反应组，但这种差异无统计学意义（=0.337）。值得注意的是，治疗反应组的平均QTd 2显著低于无治疗反应组（=0.002）。
结论
我们发现，与治疗前相比，直接血管成形术后研究患者的QTd显著降低，因此QTd可被视为STEMI患者治疗反应的一种无创测量指标。
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