| Objective: A retrospective study was conducted on the routine(electrocardiogram)ECG and echocardiographic indicators of patients with complete left bundle branch block(LBBB),and the relationship between ECG characteristics and left ventricular function and left ventricular wall motion was analyzed.To investigate the relationship between LBBB ECG characteristics and left ventricular function and left ventricular wall motion.Methods: A total of 379 inpatients diagnosed with LBBB in the affiliated hospital of zunyi medical university from July 23 th of 2016 to November 4th of 2019 were selected as the observation group,and 47 people with normal physical examination were selected as the control group.The electrocardiograms of the two groups were retrospectively analyzed,and the result of left ventricular systolic function(LVEF,LVFS)and left ventricular wall motion status(left ventricular wall motion amplitude and left ventricular wall motion synchronization)detected by ultrasonic cardiogram(UCG)and clinical data were collected.To group according to the characters of ECG,observe QRS complex duration,axis deviation,broad “M”shape in QRS wave of lead ?,the secondary changes of ST-T,poor R wave progression on left ventricular systolic function and the influence of left ventricular motion state,at the same time using Logistic regression analysis respectively to observe all kinds of characteristic of ECG on left ventricular systolic function and the influence of left ventricular motion state.Results:(1)LVEF and LVFS in the observation group were lower than that in the control group,and the difference was statistically significant(P<0.01).The incidence of decreased left ventricular wall motion amplitude in the observation group was higher than that in the control group,and the difference was statistically significant(P <0.01).The incidence of left ventricular wall movement dyssynchrony in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.01).(2)The QRS duration ?160ms group and QRS duration 120-159 ms group were compared with the control group,respectively: LVEF and LVFS were significantly reduced,the difference was statistically significant(P<0.01),the incidence of decreased left ventricular wall motion amplitude was increased(P<0.01),and the incidence of left ventricular wall motion unsynchronized was increased(P< 0.01).LVEF and LVFS were significantly reduced in the QRS duration ?160ms group compared with the QRS duration 120-159 ms group,and the difference was statistically significant(P<0.01).There was no statistically significant difference in the incidence of left ventricular wall motion dyssynchrony(P>0.0167).Logistic regression analysis suggested that ECG characteristics such as QRS duration?160ms in LBBB patients were positively correlated with LVEF reduction,LVFS reduction and left ventricular wall motion amplitude reduction(P<0.05),and QRS duration?160ms had the most significant influence.ECG characteristics such as QRS duration?160ms were not correlated with the occurrence of left ventricular wall movement unsynchronization(P>0.05).(3)LVEF and LVFS were significantly reduced in the group with and without secondary ST-T changes,and the difference was statistically significant(P<0.01).The incidence of decreased left ventricular wall motion amplitude was increased(P<0.01),and the incidence of left ventricular wall motion unsynchronized was increased(P< 0.01).LVEF and LVFS were significantly reduced in the group with and without secondary ST-T changes,and the difference was statistically significant(P<0.01).There was no statistically significant difference in the incidence of left ventricular wall motion dyssynchrony(P>0.0167).Logistic regression analysis suggested that ECG characteristics such as secondary ST-T changes in LBBB patients were positively correlated with LVEF reduction,LVFS reduction and left ventricular wall motion amplitude reduction(P<0.05).ECG characteristics such as QRS duration ?160ms and secondary ST-T changes were not correlated with the occurrence of left ventricular wall movement unsynchronization(P>0.05).(4)M shape and non-M shape,respectively,compared with control group: LVEF,LVFS decrease,the difference was statistically significant(P<0.01),left ventricular wall motion amplitude diminished incidence increased(P<0.0167),left ventricular wall motion of sync incidence increased(P<0.01).M shape compared with non-M type group comparison: LVEF,LVFS decrease,the difference was statistically significant(P<0.01);There was no statistically significant difference in the incidence of left ventricular wall motion amplitude reduction and left ventricular wall motion unsynchronization(P>0.0167).Logistic regression analysis suggested that M shape were correlated with LVEF reduction,LVFS reduction and the happening of the left ventricular wall motion unsynchronization(P<0.05),M shape were not correlated with the occurrence of left ventricular wall motion amplitude reduction(P>0.05).(5)Compared with the control group,LVEF and LVFS were significantly reduced in the left-axis and no-axis groups(P<0.01),and the incidence of decreased left ventricular wall motion amplitude was increased(P<0.01).The incidence of left ventricular wall motion unsynchronization increased in the left-leaning group without electric axis(P<0.01).There was no statistically significant difference in the incidence of left ventricular wall motion synchronization in the left axis deviation group(P> 0.0167).There was no statistically significant difference in the incidence of LVEF,LVFS,left ventricular wall motion amplitude reduction and left ventricular wall motion unsynchronization between the left axis deviation group and the left axis deviation group(P>0.0167).Logistic regression analysis suggested that the left axis deviation was negatively correlated with the occurrence of out-of-sync motion of the left ventricular wall(P<0.05),while the left axis deviation was not correlated with the occurrence of decreased LVEF,decreased LVFS,and decreased wall motion amplitude(P>0.05).(6)The group of poor R wave progression and group without the poor R wave progression compared with the control group,LVEF and LVFS decreased significantly(P<0.0167),the incidence of decreased left ventricular wall motion amplitude increased(P<0.0167),and the incidence of left ventricular wall motion unsynchronized increased(P<0.0167).The group of poor R wave progression compared with group without the poor R wave progression,there was no statistically significant difference in the incidence of LVEF,LVFS,left ventricular wall motion amplitude reduction,and left ventricular wall motion unsynchronization(P>0.0167).Logistic regression analysis suggested that there was no significant correlation between ECG features with poor R wave progression and left ventricular function and left ventricular wall motion(P>0.05).Conclusion:(1)LBBB patients had decreased left ventricular systolic function,decreased ventricular wall motion and unsynchronized ventricular wall motion.(2)The extension of QRS complex duration and the secondary changes of ST-T were related to the reduction of left ventricular systolic function,of which the extension of QRS complex duration had the greatest impact on the reduction of left ventricular systolic function.(3)The extension of QRS complex duration and the secondary change of ST-T were related to the weakening of the left ventricular wall motion amplitude,among which the extension of QRS complex duration had the greatest influence on the weakening of the left ventricular wall motion amplitude.(4)The M shape,the left axis deviation were associated with left ventricular wall motion unsynchronized,M shape had the greatest influence on left ventricular wall motion are unsynchronized.(5)The M shape,the left axis deviation,poor R wave progression had nothing to do with the left ventricular systolic function.(6)The M shape,the left axis deviation,the poor R wave progression had nothing to do with the left ventricular wall motion amplitude diminished.(7)The extension of QRS complex duration,the secondary changes of ST-T,and the poor R wave progression have nothing to do with the left ventricular wall motion unsynchronization. |
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