超声心动图参数与静息心电图在老年慢性心力衰竭患者心功能及预后评估中的应用研究

Application of echocardiographic parameters and resting electrocardiogram parameters in evaluating cardiac function and prognosis in elderly patients with chronic heart failure

中文关键词: 老年  慢性心力衰竭  二维超声心动图  静息心电图

英文关键词: elderly  chronic heart failure  two-dimensional echocardiography  resting electrocardiogram

中文摘要:

      目的 探究二维超声心动图参数[左心室舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)]与静息心电图(ST-T改变、QRS波群时限)在老年慢性心力衰竭(CHF)患者心功能及预后评估中的应用价值.方法 回顾性分析2020年1月—2024年1月无为市人民医院收治的70例老年CHF患者的临床资料.根据心功能分级(NYHA)分为Ⅱ级组(16例)、Ⅲ级组(26例)和Ⅳ级组(28例),比较3组一般资料、二维超声心动图参数与静息心电图差异,Spearman分析NYHA分级与各参数相关性.根据出院后6个月有无发生主要临床终点事件分为预后良好组(47例)和预后不良组(23例),比较2组二维超声心动图参数及静息心电图差异,绘制受试者工作特征曲线(ROC)分析各参数对预后的预测价值.结果 比较二维超声心动图参数,Ⅳ级组的EDV、ESV高于Ⅲ级组和Ⅱ级组,SV低于Ⅲ级组和Ⅱ级组(P＜0.05);比较静息心电图参数,Ⅳ级组ST-T改变率、QRS波群时限高于Ⅲ级组和Ⅱ级组(P＜0.05).NYHA分级与ED V、ESV、ST-T改变率、QRS波群时限呈正相关,与SV呈负相关性(P均＜0.05);和预后良好组比较,预后不良组患者EDV、ESV更高,SV更低,ST-T改变率和QRS波群时限更高(P＜0.05).ROC结果显示,EDV、ESV、SV、ST-T改变、QRS波群时限联合评估患者预后的AUC为0.936,敏感度为95.70％,特异性为83.00％(P＜0.05).结论 二维超声心动图参数及静息心电图参数与老年CHF患者心功能分级有关,可预测患者预后.

英文摘要:

      Objective To explore the application value of two-dimensional echocardiographic parameters[left ventricu-lar end-diastolic volume(EDV),end-systolic volume(ESV),stroke volume(SV)]and resting electrocardiogram parameters(ST-T changes,QRS complex duration)in evaluating cardiac function and prognosis in elderly patients with chronic heart fail-ure(CHF).Methods The clinical data of 70 elderly CHF patients admitted to People's Hospital of Wuwei City from January 2020 to January 2024 were analyzed retrospectively.According to the cardiac function classification(NYHA),patients were divided into class Ⅱ group(16 cases),class Ⅲ group(26 cases)and class Ⅳ group(28 cases).The differences in general data,two-dimensional echocardiogram parameters and resting electrocardiogram parameters were compared among the three groups.Spearman analysis was used to analyze the correlation between NYHA classification and each parameter.According to the occurrence of major clinical endpoint events 6 months after discharge,the patients were divided good prognosis group(47 cases)and poor prognosis group(23 cases).The differences in two-dimensional echocardiogram parameters and resting elec-trocardiogram parameters were compared between the two groups,and the receiver operating characteristic curve(ROC)was drawn to analyze the predictive value of each parameter for prognosis.Results The comparison of two-dimensional echocar-diographic parameters showed that the EDV and ESV in the grade Ⅳ group were higher than those in the grade Ⅲ group and grade Ⅱ group,while the SV was lower than that in the grade Ⅲ group and grade Ⅱ group(P＜0.05).The comparison of resting electrocardiogram parameters showed that the change rate of ST-T and QRS complex duration in the grade Ⅳ group were higher than those in the grade Ⅲ group and the grade Ⅱ group(P＜0.05).The NYHA classification was positively correlated with the EDV,ESV,change rates of ST-T and QRS complex duration,and negatively correlated with SV(all P＜0.05).Compared with the good prognosis group,the poor prognosis group had higher EDV and ESV,lower SV,higher change rate of ST-T and higher QRS complex duration(P＜0.05).The ROC results showed that the AUC,sensitivity and specificity of the combined evaluation of EDV,ESV,SV,ST-T changes,and QRS complex duration for the prognosis of patients were 0.936,95.70％and 83.00％,respectively(P＜0.05).Conclusion The parameters of two-dimensional echocardiography and resting electrocardio-gram are related to the cardiac function classification of elderly CHF patients,and can predict the prognosis of patients.