Clinic Study Of Relativity Between QTd Change And Restenosis After PCI

The first percutaneous transluminal coronary angioplasty accomplished in the world in 1977, symbolizes that coronary heart disease intervention treatment time comes. And the Stent Implantation is the most common in use in the field of heart intervention treatment. Along with the continuously development of the technique and supporting facilities ,it achieves above 95% and it's complication is lower than 5%. Indications and Usage of Stent Implantation have been widened.But the forward effect of stent implantation has been puzzled by restenosis(RS),that started at the very beginning. How to monitor the narrow process of the stent,so that to carry on target-oriented intervenes to RS,is now the hot spot.The QT dispersion(QTd) change, caused by the pathological change of coronary artery, is reported to be many, but there are few basic researches or clinical reports on the relativities between QTd change and RS .Patients are more likely to accept QTd examination for its simplicity,no wound,safety and low price, comparing with coronary angiography (CAG).Could QTd monitors the RS after PCI and what is the relativities between QTd and RS? We will discuss it from clinical research angle in the topic.objective: Discussing the relativities between QTd change and restenosis. Methods: In-hospital patients of the Heart Internal Medicine department of the first hospital the Jilin University,who had received PCI successfully during the period from January,2007-April,2008 and received tracing observation 6 months lately.At last we selected 68 patients from above members, who accepted CAG again and meet the requirements of our research.54 have RS,and the other 14 having no RS form the Control groups.All the selected members were recorded the scope and the degree of the pathological change(or RS) on relative coronary vessels( or stent) during the first CAG and the second CAG, and were also writen down the results of heart color ultra inspection ,QTd(of the third day after PCI and of the second hospital treatment), blood fats, blood sugar.blood pressure heart rates and so on. During the period of the research,people who has any of the below situation,will be withdrawn the research. Electrolyte disorder, congested heart failure, myocardiopathy, the ventricle textural anomaly, preexcitation syndrome, bundle block, diabetes in advance to present the serious complication and the blood sugar control not stability, atrial fibrillation ,taking the medicines that influence cardiac muscle heteropolar bond or having diseases which can change cardiac muscle heteropolar bond, having liver,brain,lung or haematology disease, valvular heart disease,the blood stream dynamics not stable.Carries on the grouping comparison according to three big aspects: 1. grouping according to RS narrow degree:No RS group : definition of the pathological narrow of stent <50%;Mild RS group: definition of the pathological narrow of stent≥50% and <70%;Serious RS group: definition of the pathological narrow of stent≥70%.2.grouping according to RS change scope(the number of pathological blood vessel):①Single vessel group: RS exists only in one blood vessel with narrow≥50%, this group is divided into three smaller groups: LAD group,LCX group,RCA group;②2 vessels groups: RS exists in two blood vessels with narrow≥50%;③3 vessels groups: RS exists in three blood vessels with narrow≥50%.3.grouping according to the time spot of the beginning of PCI: Emergency PCI group: definition of patients who were operated within 12 hours after they had bad symptoms; Delayed PCI group: definition of patients who were in hospital over 12 hours, and had PCI 7-10 days later.Result:1. There is no remarkable difference among each group QTd, that's gotten in any group that metioned in the research of first time in hospital (3rd day after PCI).2.the result of overall comparison of RS group and No RS group:the second time QTd of RS group is remarkablely higher than its first QTd (3rd day after PCI) ,P<0.05;the second QTd of No RS group has no remarkable change than its first QTd (3rd day after PCI),P>0.05. 3. Analysis from the narrow degree of RS:①The second time QTd of Serious RS group is remarkable bigger than its first time, P<0.05;The second QTd of the Mild RS group is remarkable higher than its first QTd (3rd day after PCI), P<0.05.The second QTd of No RS group is a little lower than its first QTd (3rd day after PCI) ,but the change is not remarkable,P>0.05②The increasing QTd change between the first time in hospital and second time in hospital on the Serious RS group is even more remarkable than that of the Mild RS group,P<0.05.4.observation according to the RS scope:The second time QTd has no remarkable difference ,between single vessel RS group and multi-vessel RS group, P>0.05; the second time QTd has no remarkable difference , between 2 vessels RS group and 3 vessels RS group, P> 0.05;there are no remarkable difference among Single vessel RS groups(LAD group,LCX group,RCA group) at second time in hospital,P>0.05.The second time QTd of all the RS groups,including Single vessel RS groups(LAD group, LCX group,RCA group) and multi-vessel RS groups(2 vessels RS group and 3 vessels RS group) are remarkable bigger that of the first time(3rd day after PCI) in hospital,P>0.05.5. study from the time spot when PCI started:The second time QTd of the Emergency PCI RS group is remarkable bigger that that of its first time(3rd day after PCI),P<0.05;The second time QTd of the Delayed PCI RS group is remarkable bigger that that of its first time(3rd day after PCI),P< 0.05;The second time QTd of the Emergency PCI RS group has no remarkable change from that of Delayed PCI RS group,P>0.05. The QTd of the Emergency PCI No RS group has the change, between the first time (3rd day after PCI) and second time in hospital, no remarkable than that of Delayed PCI No RS group, P>0.05.Conclusion:QTd increase evidently in RS patients,the increasing change is the most remarkable in Serious RS patients;QTd maybe a useful forecasting parameter in the study of RS field.