| Backgroud:The variation of QRS interval and QTcd reflect the abnormal depdarization and repolarization of cardiac ventricle and the derangement of electrophysiology afer AMI,which is closely correlated with the derangement of myocardium frame and function.QRS interval and QTcd can be used as new prognostic indexes after AMI in the early period.Objective:To analysis the QRS interval and QT dispersion(QTd)in 120 patients with AMI for the first time and to analysis the correlation to plasma Brain natriuretic peptide(BNP),so as to find indexes that can reflect heart function condition after AMI conveniently,quickly,and exactly and can forecast fatality and cardiac insufficiency in the near future after AMI.Method:One hundred and twenty inpatients with AMI for the first time were enrolled in the study.Within 24 hours after hospitalization of each patient,record sex, age,history of smoking,hypertension,diabetes,history of angina,hyperlipem,heart function classify of Killip,et al;draw blood on an empty stomach for chemical analysis of serum glucose and blood-fat,et al;determine density of BNP in plasma and undertake electrocardiography to determin QRS interval and QTcd.All the patients were reviewed and followed up in 6 weeks and echocardiography was carried out then,occurrence of congestive heart failure and death were also recorded during the follow-up. 1.Density of BNP in plasma advanced by turns according to heart function classify of Killip;logBNP,QRS interval and QTcd advanced by turns according to heart function classify of Killip,and significant difference was found during each group(P＜0.01).Heart function classify of Killip in the acute stage after AMI was positively correlated with BNP,QRS interval,QTcd,age and diabetes(r=0.556, 0.385,0.405,0.205 and 0.187 respectively:P＜0.0005,＜0.0005,＜0.0005, =0.025 and 0.040 respectively=;2.LogBNP,QRS interval and QTcd were significantly higher in patients with heart failure than in patients in control group(P＜0.01 =.LVEF of recovery phase was negatively correlated with BNP,heart function classify of Killip in the acute stage,QRS interval,QTcd and hyperlipoidemia(r=-0.577,-0.363,-0.502, -0.486 and -0.224 respectively;P＜0.0005,＜0.0005,＜0.0005,＜0.0005 and =0.019 respectively = BNP＞596pg/ml in the acute phase was an independent prognostic factor of heart failure in the near future after AMI(OR=13.512,p=0.009);QRS interval entered the regression equation at the same time(OR=4.696,P=0.055).3.Heart function classify of Killip,logBNP,QRS interval and QTcd were significantly higher in patients died than in patients survived(P＜0.01).Death in the near future after AMI was positively correlated with BNP,heart function classify of Killip in the acute stage,QRS interval,QTcd and heart rate(r=0.421,0.494,0.324, 0.460 and 0.205 respectively;P＜0.0005,＜0.0005,＜0.0005,＜0.0005 and =0.025 respectively).BNP＞596pg/ml in the acute phase was an independent prognostic factor of death in the near future after AMI(OR=24.310,P=0.016);QTcd entered the regression equation at the same time.(0R=30.363,P=0.007).Conclusion:1.BNP was significantly higher in patients went heart failure and in patients died in the near future and it was also significantly correlated with heart function classify of Killip in the acute stage,with LVEF and with death in the near future.BNP could be an independent prognostic factor of heart failure and death in the near future after AMI It might be used to distinguish insufficient heart function in the earlier period and to estimate the dangerous of death inthe earlier period.2.QRS interval and QTcd were significantly higher in patients went heart failure and in patients died in the near future and it was also significantly correlated with heart function classify of Killip in the acute stage,with LVEF and with death in the near future.QRS interval and QTcd might be used to distinguish insufficient heart function in the earlier period and to estimate the dangerous of death in the earlier period.3.QRS interval and QTcd had similar clinical application value as BNP. |
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