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Abstract Objective By analyzing dynamic changes of QT dispersion(QTd) in patients with acute myocardial infarction(AMI) after percutaneous coronary intervention(PCI), to evaluate the role PCI plays in recovering cardiac muscle after infarction and clinical values of QTd for judging the effect of PCI treatment and prognosis of AMI patients. MethodsThirtyfive AMI patients in our hospital from September 2013 to March 2014 were enrolled, among whom were 15 cases successfully undergone emergency PCI treatment within 2 weeks and 20 cases treated by delayed surgery. We collected 12lead ECGs on their admission, and separately 6 h, 12 h, 24 h and 48 h after PCI, and then measured QTd. ECGs on admission, 2 days and 1-2 weeks after admission were also collected from 30 AMI patients in our hospital from 2010 to 2011 who only had taken medical treatment without thrombolysis or PCI surgery, and their QTd was measured. Another 30 healthy people were regarded as control group. ResultsCompared with the control group, QTd of AMI treatment group increased before and 48 h after PCI surgery and the difference was statistically significant(P<0.001). The decrease of QTd 48 h after PCI surgery among AMI treatment group was significantly different from that before PCI surgery(P<0.001). Compared with the nontreatment group, decrease of QTd was found at the same time point for both emergency treatment group and delayed treatment group, and the drop of the former was bigger than that of the latter.ConclusionIt reveals by the dynamic changes of QTd in AMI patients after PCI surgery that with the recanalization of occluded coronary artery, myocardial oxygen and blood supply will increase, normal cardiac electrophysiology can be restored, and the inconsistency of ventricular repolarization will be improved. In addition, if compared with delayed PCI surgery, emergency PCI surgery is capable of reducing QTd more quickly and significantly.
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[1] Day CP, McComb JM,Campbell RW. QT dispersion: an indication of arrhythmia risk in patients with long QT intervals[J]. Br Heart J, 1990, 63(6):342-344.[2] 杨炜, 郑新权. 急性心肌梗死QT离散度与恶性室性心律失常关系的探讨[J]. 心电学杂志, 2011, 30(4):309-310, 313.[3] 刘健, 丛洪良. 冠心病介入治疗的进展[J]. 医学综述, 2008, 14(16):2512-2516.[4] Liew R. Prediction of sudden arrhythmic death following acute myocardial infarction[J]. Heart, 2010, 96(14):1086-1094.[5] Lowe MD, Rowland E, Brown MJ,et al. Beta(2) adrenergic receptors mediate important electrophysiological effects in human ventricular myocardium[J]. Heart, 2001, 86(1):45-51.[6] 党群, 张博雅, 金喆, 等. QTc离散度变化在ACS患者PCI术后心脏事件发生中的作用[J]. 天津医药, 2009, 37(11):969-970.[7] van de Loo A, Arendts W, Hohnloser SH. Variability of QT dispersion measurements in the surface electrocardiogram in patients with acute myocardial infarction and in normal subjects[J]. Am J Cardiol, 1994, 74(11):1113-1118.[8] Higham PD, Campbell RW. QT dispersion[J]. Br Heart J, 1994, 71(6):508-510.[9] 李方安. 急性心肌梗死患者早期QT离散度与室性心动过速的关系[J]. 中国中医药现代远程教育, 2012, 10(5):98, 110.[10] 张春来, 尚小明, 纪征, 等. QT间期离散度对急性心肌梗死患者经皮冠状动脉介入治疗后主要心血管事件的预测价值[J]. 中国循环杂志, 2012, 27(6):431-434. |
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