ABSTRACT
Objective: To explore correlation between QRS complex duration and left ventricular ejection fraction (LVEF) in patients with complete left bundle branch block (CLBBB).Methods: A total of 213 patients, who were diagnosed as left bundle branch block by ECG in our hospital from Feb 2012 to Jun 2013, were selected.According to QRS complex duration, patients were divided into CLBBB group (n=182) and incomplete left bundle branch block (ICLBBB) group (n=31).Linear correlation analysis was used to analyze the correlation between QRS complex duration and LVEF, and receiver operating characteristic curve (ROC) was used to analyze optimal cutoff point of QRS complex duration for predicting LVEF<50%.Results: Compared with ICLBBB group, there was significant rise in QRS complex duration [(104.61±8.85) ms vs.(149.36±17.25) ms] and significant reduction in LVEF [(54.26±4.96)% vs.(45.22±12.57)%] in CLBBB group, P<0.01 both.Linear correlation analysis indicated that QRS complex duration was significant inversely correlated with LVEF (r=-0.55, P=0.001) in CLBBB patients.ROC analysis indicated that optimal cutoff point of QRS complex duration for predicting LVEF<50% was 151ms, the area under the curve was 0.79 (P=0.001),its sensitivity was 68.1% and specificity was 83.5%.Conclusion: QRS complex duration is significant inversely correlated with LVEF in CLBBB patients, which can be used as a simple index predicting reduced LVEF.
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To evaluate the prognostic value of glycated haemoglobin (HbA1c) in patients with acute myocardial infarction (AMI). Methods: A total of 1952 AMI patients were retrospectively studied. Based on medical history and HbA1c level, the patients were divided into 4 groups: Diabetes mellitus (DM) group, the patients with known DM or taking hypoglycemic drugs, n=492, Newly diagnosed DM group, MD was diagnosed during hospital stay and HbA1c≥6.5%, n=128, Pre-DM group, HbA1c 5.7%-6.4%, n=783 and Non-DM group, HbA1c<5.7%, n=549. The patients were followed-up for 25.6 months, prognostic differences during hospital stay and follow-up period were assessed by single- and multi-factor analysis. Results: The in-hospital mortality in DM group, Newly diagnosed DM group, Pre-DM group and Non-DM group were 4.88%, 3.91%, 3.96% and 2.91% respectively, P=0.435. As HbA1c level increasing, the incidences of all-cause mortality, non-fatal MI and re-hospitalization were elevating, while the differences among groups were similar. The incidences of major adverse cardiovascular events (MACE) in above 4 groups were 39.84%, 35.94%, 33.97% and 27.87% respectively, P=0.001. Compared with Non-DM group, MACE incidences in the other 3 groups were as OR=1.33, 95% CI 1.05-1.69, OR=1.45, 95% CI 0.97-2.18 and OR=1.71, 95% CI 1.32-2.22 respectively, Ptrend<0.001; with adjusted baseline parameters, Ptrend=0.008. Conclusion: In our research, MACE incidence was increasing upon HbA1c level elevating in AMI patients and it was not related to in-hospital death. HbA1c level should be screened in AMI patients, lifestyle and drug intervention could be used as necessity.
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Objective:To explore diagnostic value of nocturnal ST-T changes in 24h dynamic electrocardiogram (DCG)for coronary heart disease (CHD)and its clinical significance.Methods:A total of 103 cases,who showed ST-T changes in 24h DCG,received selective coronary angiography (CAG).Among them,the 56 patients with in-termittent nighttime significant ST-T changes were regarded as research group,while the other 47 patients with per-sistent ST-T changes were treated as control group.CAG results were compared and analyzed between two groups. Results:Compared with control group,there were significant rise in CAG positive rate (31.9% vs.67.9%),inci-dence rates of dyspnea and chest pain (27.7% vs.66.1%),hypertension (48.9% vs.71.4%),hyperlipidemia (31.9% vs.42.9%)and diabetes mellitus (17.0% vs.46.4%),percentages of lesions in left anterior descending artery (LAD,21.3% vs.57.1%),left circumflex coronary artery (LCX,14.8% vs.37.5%)and right coronary artery (RCA,12.8% vs.35.7%)in research group,P <0.05 or <0.01. Conclusion:Nocturnal ST-T signifieantly changes in 24h DCG,it possesses more diagnostic value for CHD,which can be regarded as a more sensitive index diagnosing myocardial ischemia.