The Clinical Analysis Of Retrospective And Prospective Studies On Non-invasive Detection Indicators For Predict The Sudden Cardiac Death

Objective:To explore the most valuable non-invasive detection and the predicative index optimization grouping through retrospective and prospective data collection and study on the non-invasive detection indicator of Sudden Cardiac Death (SCD) patients ,in order to predict and intervene the SCD as early as possible.Methods:1. One hundred patients of sudden cardiac death were enrolled, and the patients who were with the general and similar cases but no obvious organic heart diseases were selected as control. Then ultrasonic left ventricular ejection fraction (LVEF), ECG QRS width, QT interval, QTc, Frequent PVCs, Non-sustained ventricular tachycardia etc of all patients were collected and analyzed.2. Fifty patients at high risk for sudden death were collected to prospective follow-up study, and at the same time, the patients with some similar cases no obvious organic heart disease were choose to compare. Ultrasonic left ventricular ejection fraction (LVEF), ECG QRS width, QT interval, QTc, Frequent PVCs, Non-sustained ventricular tachycardia, SDNN, Heart Rate Turbulence etc were collected. Followed-up once three months in one year, and their association to the sudden cardiac death or ventricular fibrillation was studied using logistic regression analysis.Results:1. Compared with the QRS width,QT,QTc in SCD and the control group, showed that the data of the SCD group are increased, and there were significant differences (P <0.05).2. Single-factor analysis on retrospective data showed that it has the highest death proportion when LVEF at 31-35%, followed by 36-40%, when LVEF> 40%, with LVEF was high increased, proportion of deaths reduced. However, when LVEF <26%, it is low. Compared with LVEF at 41-45% ,LVEF at 26-30%,31-35% and 36-40% were separately significant differences (P <0.05). Compared with LVEF at 26-30% the death proportion were significantly increased on LVEF at 31-35% and 36-40% (P <0.05)3. Single-variable analysis on prospective data showed TO,ventricular late potentials,QTc,TS,LVEF (<35%),SDNN were associated with sudden cardiac death (P <0.05), Multivariate regression analysis showed TS,LVEF,SDNN were influencing factors for sudden cardiac death (P <0.05), and TS could showed as a strong predictor for the SCD.4. Combined the two separate indicators which were not associated with sudden cardiac death in the multivariate regression analysis. The combined group become significant and had higher predictive value, such as the combination of LVEF (35-40%) and ventricular late potentials; the combination of TO and TS.Conclusions:Mortality is high on the patients with organic heart disease such as Coronary heart disease, dilated cardiomyopathy. Sudden cardiac death may be associated with TS, LVEF (<35%), SDNN, the combination of LVEF (35-40%) and ventricular late potentials, they are of clinical significance.