急性心肌梗死恢复期V1导联P波终末电势与左室舒张功能的相关性研究

Relation between P wave terminal force in lead V1 and left ventricular diastolic function after acute myocardial infarction

摘要:

目的  探讨急性心肌梗死（AMI）患者恢复期心电图V1导联P波终末电势（Ptfv1）与左心室舒张功能的相关性。方法  选择78例AMI后6周左右[（41.76±4.28）d]心电图Ptfv1≤-40 mm/s的患者为观察组，以及同期86例心电图Ptfv1>-40 mm/s的AMI患者为对照组。比较两组间超声心动图左房内径（LAD）、左室舒张期直径（LVDd）、左室等容舒张时间（LVRT）、二尖瓣舒张早期流速峰值（E）、二尖瓣舒张晚期流速峰值（A）、左心室射血分数（LVEF）、组织多普勒舒张早期二尖瓣环水平心肌速率峰值（E'）、E/A及E/E'等。结果  观察组LVDd、LAD、LVRT增大（P <0.05），观察组LVEF减低（P <0.01），观察组中E/A值降低（P <0.025），观察组E及E'峰值减小（P <0.05），E/E'值増高（P <0.05），观察组E'<9 cm/s、E/E'>8及15的例数增多（P <0.05）。结论  在AMI恢复期患者中，Ptfv1值异常反映左心室舒张功能减退。测量Ptfv1是简单易行的初步评估左室舒张功能方法。

Abstract:

Objective To evaluate the relation between P terminal force in lead V1 (Ptfv1) and the left ventricular diastolic function during recovery stage of acute myocardial infarction (AMI). Methods Seventy-eight AMI patients whose Ptfv1 was ≤ -40 mm/s about 6 weeks [(41.76 ± 4.28) days] after the onset of AMI were chosen to be the study group, while other 86 AMI patients whose Ptfv1 was > -40 mm/s were chosen to be the control group. On the day while the Ptfv1 was measured, every patients had ultrasonic echocardiography examination to measure left atrial diameter (LAD), left ventricular diastolic diameter (LVDd), left ventricular isovolumic relaxation time (LVRT), early diastolic peak velocity of mitral valve (E), late diastolic peak velocity of mitral valve (A), left ventricular ejection fraction (LVEF), early diastolic peak velocity of mitral annulus(E′), E/A and E/E. All the values were compared between the two groups. Results LVDd, LAD and LVRT increased (P < 0.05) while LVEF decreased (P < 0.01) in the study group. While E/A was lower (P < 0.05), E and E' were also lower (P < 0.05) and E/E' was higher (P < 0.05) in the study group. The cases of E' < 9 cm/s and E/E' > 8 or 15 were more in the study group than in the control group (P < 0.05). Conclusions The abnormal value of Ptfv1 is related with decreased left ventricular diastolic function after AMI. Measurement of Ptfv1 is a simple and useful way to evaluate left ventricular diastolic function after AMI.