不同NYHA分级慢性心力衰竭患者心肌纤维化指标水平与心电图变化的临床意义

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Abstract Objective To investigate the changes of myocardial fibrosis indexes and the end-stage changes of ST-T and T peaks in patients with chronic heart failure of different NYHA grades and their clinical significance.Methods Between October 2014 and October 2017, 93 patients with CHF were enrolled in the study group, while another 93 healthy subjects were selected as the control group. All the subjects received an electrocardiogram examination. The Tp-Te intervals in both groups, ST-T changes and the Tp-Te intervals between the NYHA patients in the study group, and the serum myocardial fibrosis indexes [Laminin (LN), pre-Ⅲ collagen (PCⅢ), hyaluronic acid (HA)] were calculated. The correlations of ECG ST-T changesand Tp-Te intervals with NYHA classification of CHF patients and between serum LN, PCⅢ, HA levels and NYHA classification of CHF patients were statistically analyzed.Results The Tp-Te (100.23±19.07) ms and Tp-Te/√RR (3.71±0.69) ms in the study group were larger than in the control group, and the RR (785.67±123.34) ms was smaller than in the control group (P<0.05). There was significant difference in ECG ST-T changes, Tp-Te and RR, Tp-Te/√RR between patients with different NYHA classification (P<0.05). However, there was no significant difference between the grade Ⅱ patients and grade Ⅲ patients. The level of ST-T changes in grade Ⅳ patients was higher than that in grade Ⅱ and Ⅲ patients, Tp-Te and Tp-Te/√RR were greater, but RR was lower than in grade Ⅱ and Ⅲ patients (P<0.05). One-way ANOVA showed that there was significant difference in serum LN, PCⅢ, and HA levels between different NYHA patients (P<0.05). After multiple comparisons, serum LN, PCⅢ, and HA levels were higher in grade Ⅲ patients than those of grade Ⅱ (P<0.05). Serum LN, PCⅢ, and HA levels were higher in grade IV patients than in grade Ⅲ patients (P<0.05). There was a significant positive correlation between ECG ST-T change, Tp-Te and Tp-Te/√RR and NYHA classification, but there was a significant negative correlation between RR and NYHA classification. There was a significant negative correlation between the grades (P<0.05),but there was a significant positive correlation between LN, PCⅢ, and HA levels and NYHA classification (P<0.05).Conclusions The ECG ST-T is significantly changed in patients with chronic heart failure, the end of T wave peak increases, and the level of myocardial fibrosis is abnormally increased.

Key words： NYHA classification chronic heart failure electrocardiogram ST-T peak-T end interval

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	LIU Xiaoling
	GAO Shiding

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LIU Xiaoling,GAO Shiding. Changes of myocardial fibrosis indexes and of ST-T and T peaks in patients with chronic heart failure with different NYHA classification and their clinical significance[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2018, 29(11): 1028-1031.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2018/V29/I11/1028

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