The Study Of Relationship Between Traditional Chinese Medicine (TCM)Syndrome Types Of Coronary Heart Disease And Fragmented QRS And Lipoprotein Associated Phospholipase A2

ObjectiveTo observe the incidence and distribution of fragmented QRS and lipoprotein associated phospholipase A2 in various TCM syndrome types of coronary heart disease(CHD), which it is aiming to reveal the correlation between Traditional Chinese Medicine syndrome type of coronary heart disease and Fragmented QRS (fQRSs) and lipoprotein associated phospholipase A2 (Lp-PLA2).MethodsTo select 586 cases of hospitalized patients with chest pain who were admitted in cardiovascular department of Guangzhou University of Chinese Medicine First Affiliated Hospital and have underwent percutaneous coronary artery intervention treatment in Jan,2013 to Oct,2014 through retrospective studyo The patients who complied with the standard of CHD, and whose coronary angiography indicated that the coronary artery stenosis≥50%, would be divided into the CHD group. Then, the patients whose coronary angiography indicated that the coronary artery were normal, without coronary artery stenosis or coronary atherosclerotic plaque, would be divided into the control group. Meanwhile, all the TCM syndrome types of the patients would be divided into Noxious Heat stasis type, Phlegm and blood stasis type, Qi stagnation and blood stasis type, Qi deficiency and blood stasis type, Qi and Yin deficiency with blood stasis type. Finally,the various TCM syndrome types of two groups’ patients would be compared in baseline data, fQRSs, Lp-PLA2, the number of vascular lesion of coronary artery and Gensini scores,etc.Results1. The presence of fQRSs in ECG have relevance with the CHD (P<0.01). The incidence of fQRSs of the CHD group was significantly higher than that in the control group, the difference was statistically significant (/)<0.01). The CHD patients with different numbers of diseased vessel had different incidence of fQRSs in ECG(P<0.01). The incidence of fQRSs in multivessel disease was higher than the double vessel disease and the single-vessel disease, which indicated that the more number coronary vessel disease, the more incidence of fQRSs. The incidence of fQRSs in each kind of the CHD was different (P<0.01), which was the highest in acute myocardial infarction(AMI), and followed by unstable angina(UA), stable angina(SA)and asymptomatic myocardial ischemia. The patients who showed fQRSs in ECG had higher Gensini scores than the patients who didn’t showed(P<0.01). In the other words, the higher Gensini score in the CHD patients, the higher detection rate of fQRSs in ECG, and the more severe coronary artery lesions.2.The level of Lp-PLA2 in CHD group was higher than in control group (P <0.01). The level of Lp-PLA2 in different numbers of diseased coronary vessel had no significantly difference (P>0.05). The level of Lp-PLA2 was different in each kind of the CHD (P<0.01). The level of Lp-PLA2 in AMI was higher than UA, SA and asymptomatic myocardial ischemia. The level of Lp-PLA2 in patients with CHD was positively correlated with Gensini score (r=0.194, P<0.01).3. The various TCM syndrome types of CHD were different between the CHD group and the control group (P<0.01). The Noxious Heat stasis type had the largest numbers of the patients in the CHD group, then followed by Phlegm and blood stasis type, Qi deficiency and blood stasis type which was equal to Qi and Yin deficiency with blood stasis type, and Qi stagnation and blood stasis type which was the least. However, the Qi stagnation and blood stasis type had the largest numbers of the patients in the control group, while there was little difference in the others.4. The distribution of various syndrome type of the CHD were different from the multivessel disease to non-multivessel disease (P<0.05). The multivessel disease was mainly the patients of Noxious Heat stasis type, and the rate of Noxious Heat stasis type in the multivessel disease was higher than in the non-multivessel disease’s. The distribution of various syndrome type of the CHD were different from Acute coronary syndrome (ACS) to non-ACS (P<0.05) The patients of ACS were mainly Noxious Heat stasis type, while the patients of non-ACS were mainly Phlegm and blood stasis type.5. The distribution of various syndrome type of the CHD was different in the fQRSs group and the non fQRSs group (P<0.01). The numbers of patients with Noxious Heat stasis type in the fQRSs group were more than Phlegm and blood stasis type, Qi deficiency and blood stasis type, Qi and Yin deficiency with blood stasis type, and Qi stagnation and blood stasis type (P<0.006). The Presence of fQRSs have relevance with the TCM syndrome types in the CHD group (P<0.01), in which the Pearson contingency coefficient was 0.221.6.The level of Lp-PLA2 of the various TCM syndrome types in CHD had no significantly difference (P>0.05). However, the level of Lp-PLA2 of Noxious Heat stasis type in CHD group was higher than in control group (P<0.05). It indicated that the CHD patients with high level of Lp-PLA2 were mainly Noxious Heat stasis type.ConelusionThis study showed that fQRSs and the levels of Lp-PLA2 had close relationship with the Noxious Heat stasis syndrome type of CHD. When the patients had coronary artery disease, they might be predicted to have a higher incidence of fQRSs and higher levels of Lp-PLA2, who were identified as Noxious Heat stasis syndrome type, indicating a high severity of coronary heart disease and poor prognosis. Thus, the patient like that need to strengthen the monitoring and feather treatment.