The Correlation Analysis Of Left Ventricular Remodeling In Dilated Cardiomyopathy, Cardiac Function And Ventricular Arrhythmias

Objective:By analyzing the electrocardiogram(ECG) and cardiac magnetic resonance imaging of 60 DCM patients, this paper discusses the correlation of left ventricular remodeling in dilated cardiomyopathy, cardiac function and ventricular arrhythmias. Methods:60 cases, including 41 males and 19 females, were researched. Their average ages were 52.3 ± 11.5. We recorded their LVEDD of left ventricular remodeling indicators and LVEF of SI- 1 and the left ventricular systolic function. According to left ventricular ejection fraction LVEF > 40%, 40-35%, < 35%, three groups were divided. According to the cardiac function class II, III, IV, three groups were also divided. According to whether patients have serious ventricular arrhythmia when being admitted to the hospital, two groups, serious ventricular arrhythmia and non serious ventricular arrhythmia, were divided. And then we analyzed and compared the left ventricular remodeling indicators LVEDD and SI- 1 in each group. And according to the LVEDD<60mm, 60 mm to 70 mm, > 70 mm, we divided the 60 cases into three groups. According to SI-1 < 0.6, 0.6-0.7, > 0.7, we also divided 60 cases into three groups. At last, we counted up the incidence of arrhythmia in each group. Results:1. 60 patients with dilated cardiomyopathy(DCM) included 41 males and 19 males. The ratio of male to female was 2.16:1; Their age were among 35-67. The average ages were 52.3 ±11.5. Among them, 36(60%) developed ventricular arrhythmias, including 13(21.7%) cases of occasional ventricular premature beat and 23 cases(38.3%) of serious arrhythmia. In the 23 patients developing sevious arrhythmia, 11(18.3%) had frequent ventricular premature beat and 12(20.0%) had brief paroxysmal tachycardia.2. From the analysis of left ventricular remodeling LVEDD and the LVEF of SI- 1 and left ventricular systolic function, we can see the obvious negative correlation relationship. With the fall of LVEF value, LVEDD and SI- 1 obviously increased. And the correlation coefficient was 0.648 and 0.735 respectively. Meanwhile, p values < 0.01. All this had a significant statistical meaning. And the coefficient of SI–1 was significantly higher than LVEDD.3. We compared all index of left ventricular remodeling of the DCM heart function. To the cardiac function level IV patients and patients whose LVEDD and SI-1 were greater than that of Level II, p < 0.05. This difference was statistically significant. Compared with patients of level III, p > 0.05, no statistical difference existed; Along with the reducing of the cardiac function, SI – 1 increased.4. In the comparison of left ventricular remodeling indicators, the LVEDD and SI- 1 of the patients with severe ventricular arrhythmia were significantly higher than those with non serious ventricular arrhythmia, and p < 0.05. This difference was statistically significant.5. According to the NYHA heart function classification standard, and cardiac function in different patients with DCM merge the comparison of ventricular arrhythmias: DCM patients cardiac function of Level III were 25. Cardiac function of Level IV were 22. They took up 78.33% in this group of patients. Patients with cardiac function Level III and Level IV were associated with a greater incidence of arrhythmia of ventricular arrhythmia. And the heart function of class III, IV level in patients with sporadic contracts before sexual period rate higher than that of patients with cardiac function grade II, p < 0.05. This difference was statistically significant; Cardiac function level III and IV level in patients with ventricular tachycardia and the incidence of frequent or contracts before sexual period was higher than the heart function class II patients, with a significant difference, p< 0.05, with statistical significance.6. Compare the incidence of ventricular arrhythmia of all the DCM patients with left ventricular remodeling indicators LVEDD < 60 mm patients, and the incidence of ventricular arrhythmia LVEDD60 ~ 70 mm group, LVEDD > 70 mm group, p< 0.05, significant difference was statistically significant. And we compared LVEDD > 70 mm with LVEDD 60 ~ 70 mm, p > 0.05. From this, we know that no significant statistical significance existed.7. The incidence of ventricular arrhythmia of DCM group left ventricular remodeling index SI- 1: with the increase of SI- 1, the incidence of ventricular arrhythmias reduced and the incidence of ventricular arrhythmias increased. We compared the incidence of ventricular arrhythmia of SI- 10.6-0.7 groups, SI- 1> 0.7 groups and SI – 1<0.6 group, p < 0.05. And we compared SI- 10.6-0.7 groups with SI- 1> 0.7 groups, p > 0.05. From this, we know that no significant statistical significance existed. Conclusion:1. The index LVEDD and SI- 1 of left ventricular remodeling in patients with dilated cardiomyopathy(DCM) had obvious correlation with left ventricular systolic function indexes LVEF, and the correlation coefficient of SI- 1 was higher than that of LVEDD. This shows that changes in left ventricular morphology are more valuable in evaluating left ventricular systolic function than those in the size of the diameter.2. As the degree of left ventricular remodeling increased, cardiac function and left ventricular ejection fraction were reduced, and the clinical significance of the degree of left ventricular spherize simple lines with the increase was more obvious than that of the increase of diameter size. This shows that the value of the spherical index evaluation and prognosis that measure left ventricular morphology change is bigger.3. The rate for DCM patients to have ventricular arrhythmia was high(60%), And the incidence of severe ventricular arrhythmia was 38.3%. The occurrence of the occasional ventricular arrhythmia and severe ventricular arrhythmias was associated with left ventricular remodeling. This shows that the higher the LVEDD and SI – 1 are more prone ventricular arrhythmia and severe ventricular arrhythmias will occur more often, and of the two indexes.