Goldberger心电图三联征对老年缺血性心力衰竭预后评估的研究

A study on prognosis evaluation of elderly patients with ischemic heart failure by Goldberger's triad

中文关键词: 老年  缺血性心力衰竭  Goldberger三联征  肢体导联低电压  心血管不良事件  预后

英文关键词: elderly  ischemic heart failure  Goldberger's triad  low voltage in limb lead  cardiovascular adverse event  prognosis

中文摘要:

      目的 分析Goldberger心电图三联征对老年缺血性心力衰竭患者预后评估的价值.方法 回顾性选取2016年1月—2022年12月于上海市静安区中心医院就诊的老年缺血性心力衰竭患者86例.随访记录患者自缺血性心力衰竭诊断后,5年内有无主要心血管不良事件(MACE)发生,主要包括心力衰竭再住院、恶性心律失常、心源性猝死,将患者分为事件组(n=38)和无事件组(n=48).比较2组基本资料、心电图特征等;绘制ROC曲线分析Goldberger三联征对患者不良预后的预测价值.结果 与无事件组比较,事件组患者NT-pro BNP、CA125、肌酐、QTc间期值均更高,左心房内径更大,NYHA心功能分级更严重(P＜0.05).ROC曲线结果显示,Goldberger心电图三联征中肢体导联低电压可预测患者MACE事件发生(AUC为0.751、95％CI为0.661～0.841、P=0.002);而胸前导联高电压、胸前导联R波递增不良的预后预测价值不大.结论 Goldberger心电图三联征,尤其肢体导联低电压,对老年缺血性心力衰竭患者5年MACE事件发生有一定的预测价值,结合其他指标识别高危人群,具有一定的临床应用价值.

英文摘要:

      Objective To analyze the value of Goldberger's triad in prognosis assessment of elderly patients with ische-mic heart failure(IHF).Methods A total of 86 elderly IHF patients treated in Center Hospital of Jing'an District,Shanghai,between January 2016 and December 2022 were retrospectively selected.They were followed up to record the occurrence of ma-jor adverse cardiovascular events(MACE)within 5 years after the diagnosis of IHF,mainly including rehospitalization due to heart failure,malignant arrhythmia,and sudden cardiac death.Then the patients were divided into event group(n=38)and non-event group(n=48).The basic data and electrocardiographic features were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of the Goldberger's triad for adverse progno-sis.Results Compared with the non-event group,the event group had significantly higher levels of NT-proBNP,CA125,cre-atinine and QTc interval,larger left atrial diameter,and more severe NYHA cardiac function grade(all P＜0.05).The ROC curve results showed that low voltage in limb leads in the Goldberger's triad could predict the occurrence of MACE in patients(AUC was 0.751,95％CI was 0.661-0.841,P=0.002).However,the prognostic predictive value of high voltage in the precordial leads and poor R-wave progression in the precordial leads was not significant.Conclusion Goldberger's triad,espe-cially the low voltage in limb leads,has certain predictive value for the occurrence of MACE within 5-year in elderly IHF pa-tients.Combined with other indicators,it may help identify high-risk populations and has certain clinical application value.