| Objective: To investigate the influence of PCI surgery on dynamic changes of QTdispersion in patients with acute myocardial infarction(AMI). Comparing the dynamicchange of QT dispersion, we assess the role of recovery of the acute myocardial infarctionby PCI surgery, analyze the value of QT dispersion for clinical judgement with PCItreatment in the acute myocardial infarction patients.Methods: Collected35patients in our department from September2013to March2014ofdiagnosis of acute myocardial infarction admitted, in line with the WHO diagnostic criteriafor AMI, and successed in the percutaneous coronary angioplasty with stent surgery in twoweeks.15cases were treated with emergency PCI surgery and20cases were treated withdelayed PCI surgery. The coronary flow grade had achieved TIMI3level standards afterrevascularization. Collected12-lead ECG by manual mode of every patient in immediatelybehospitalized time (before surgery), and after the surgery in6H、12H、24H、48Hrespectively. Measured QTd. Analyzed dynamic change of the groups at different time.Collected30patients of acute myocardial infarction without thrombolysis and PCI surgery.Measured their QTds in immediately behospitalized time、in2days and in1-2weeks.Made a normal control group with30healthy people. Recorded blood pressure、myocardialenzymes、biochemical tests as clinical indicators of every patient, for comprehensivestatistical analysis.Rezult: The QTds of AMI patient with PCI surgery were69.0±11.6ms、56.1±10.1ms、53.7±10.1ms、50.6±9.3ms、47.9±9.0ms before the surgery and after the surgery in6H、12H、24H、48H respectively, while the emergency surgery group were68.7±10.1ms、51.7±8.6ms、48.7±8.5ms、45.7±8.0ms、43.3±7.5ms respectively,and the delayed surgerygroup were69.3±12.8ms、59.5±10.0ms、57.5±9.7ms、54.2±8.9ms、51.3±8.7ms, and the healthy group were30.7±7.8ms. QTds of non-surgery group were69.5±10.5ms、71.3±8.3ms、60.2±8.0ms respectively. Compared with30healthy people, the QTd of AMI grouphas increased with statistically significance (P <0.05). QTd decreased in all patients afterPCI. There was significant reduction before-and-after surgery, and also significantreduction with-and-without surgery. With prolonged postoperative time, QTd showed aslow downward trend. The QTd of emergency PCI group decreased greater and faster thanthe delayed group at the same time.Conclusion: The dynamic change of QT dispersion in patients with diagnosed acutemyocardial infarction after PCI surgery showed that it can increase myocardial oxygensupply and blood supply by recanalization of occluded coronary artery to restore normalcardiac electrophysiology, improving the inconsistency of ventricular repolarization.Compared with delayed PCI surgery, the emergency PCI surgery reduce the QT dispersionmore quickly and more significantly. QT dispersion can be used as a good non-invasivemethod for measuring ventricular repolarization, which have clinical value forpostoperative evaluation of myocardial infarction with PCI surgery. |
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