| Ojective: To investigate roles of QT dispersion on prognostic factors in patients with CHD and influences of direct PCI on regional ventricular repolarization by determinating changes of QT dispersion in patients with AMI after PCI.Methods: 120 consecutive patients with CHD in GXMU The First Affiliated Hospital on the time between Oct 2006 and Oct 2007 were included. All the patients received CAG, standard 12-lead electrocardiography(ECG) and determination of myocardial enzyme. Data of age, gender, blood pressure and blood lipid of patients were collected. Patients were divided into four group of AMI with emergency PCI group (n=30), AMI with delayed PCI group(n=30), angina pectoris with PCI group (n=30) and CAG nagetive (n=30) group for contrast. All the patients included wre received standard 12-lead ECG before CAG. Data of QTD were gained on the time of immediately after PCI, 1 day, 3day, 5day after PCI. We performed analysis of QTD: AMI vs CAG negative; AMI with emergency PCI vs AMI with delayed PCI; AMI with delayed PCI vs angina pectoris with PCI.Rusults: QTD in patients with AMI is higer than in CAG negative. (72.32±17.33ms,76.05±17.77ms vs 35.09±10.02ms, P<0.01); statistically significance were observed between AMI with emergency PCI and AMI with delayed PCI in QTd of immediately after PCI(49.05±14.18ms vs 57.77±17.09ms P<0.05), 1 day(46.05±10.72ms vs 54.16±15.51ms P<0.05), 3day(43.23±7.32ms vs 48.44±11.34ms P>0.05), 5day after PCI(40.04±2.78 vs 44.95±9.18ms P<0.05); QTd of before PCI in emergency PCI is higher compared with that immediately after PCI(72.32±17.33ms vs 49.05±14.18ms P < 0.05), as well as when compared with QTd of 3 days after PCI (72.32±17.33ms vs 43.23±7.32). QTd in CAG negative group is lower than that in AMI with emergency PCI group (P<0.001), AMI with delayed PCI group(P<0.001), angina pectoris with PCI group(P<0.05); statistically significance was also detected in AMI with emergency PCI compared with angina pectoris with PCI(P<0.05) and AMI with emergencey PCI compared with AMI with delayed(P<0.05)Conclusion: QTD in patients with AMI in obvious high than who with CAG negative. Successfully PCI can revive hibernating myocardium and restroe its electrical activity, improved repolarization heterogeneity of ventricular myocardium, what's more, emergency PCI can restore myocardial perfusion, thus, decrease QTd. QTd which can well indicate ventricular repolarization heterogeneity is a simple, repeatable, non-invasive way to predict prognosis on CHD patients.
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