The Study On The Repolarization Reserve Function In Patients With Myocardial Ischemia

Objective1.Studies reflect the indicators between QT ventricular repolarization in no rmal and myocardial ischemia in patients with features.2.Discussion on the repolarization reserve capacity in patients with myocar dial ischemia on Repolarization in patients experiencing adverse events reserve study with a view to providing repolarization reserve side quantitative standard s for clinical.Materials and methodsThis study is divided into four parts:Part I select the second Hospital of Shanxi Medical University, January1,2010--December31,2013examination of treadmill exercise test in patients wi th negative67cases. Male female33,34cases, measurement of treadmill exer cise test before exercise starts;90times per minute in the movement,120tim es per minute, fast heart rate; motor after the recovery period is1minute,3minutes, heart rate and QT interval QTc values after the calculation with BaZe tt’s correction, and statistical analysis of results, discussion of normal Repolariz ation reserve function.Part II select the second Hospital of Shanxi Medical University, January1,2010--December31,2013, suspicious checks of treadmill exercise test-positive-positive and-negative patients200cases (age, gender, matching) with myocardi al ischemia group (positive group) in67cases, groups of suspected myocardial ischemia group(suspected positive group)66patients and normal control grou p (negative), retrospective analysis of67cases. Measurement of treadmill exerc ise test before exercise starts;90times per minute in the movement,120time s per minute, fast heart rate; motor after the recovery period is1minute,3m inutes of heart rate, that measures RR interval, QT interval and QTc values af ter the calculation with BaZett’s correction, and statistical analysis of results, di scussion on patients with myocardial ischemia and normal Repolarization reserv e differences.Part III collection made in49cases of myocardial ischemia in patients wi th coronary angiography of patients positive coronary angiography of9cases (coronary heart disease), negative for the40cases. Measurement of treadmill exercise test before exercise starts;90times per minute in the movement,120times per minute, fast heart rate; motor after the recovery period is1minute,3minutes of heart rate, that measures RR interval, QT interval and QTc val ues after the calculation with BaZett’s correction, and will results for statistics analysis, discussion Crown pulse contrast positive patients and Crown pulse co ntrast positive patients complex very reserves of differences.Part IV Follow-up200cases patients, excluded lost visit who31cases (1ost visit rate15.5%) found occurred eventually bad event for33cases, then re called sexual analysis33cases occurred bad event patients and133cases is n ot occurred bad event patients.Measurement of treadmill exercise test before ex ercise starts;90times per minute in the movement,120times per minute, fast heart rate; motor after the recovery period is1minute,3minutes of heart ra te, that measures RR interval, QT interval, QTc value.and with occurred bad e vent patients’s QTc value draws the subject that receiver operateing characterist ic curve (ROC).Result1.With the increase of speed of treadmill exercise in normal subjects, bet ween RR progressively shorter, and also shorten the QT interval, as the move ment after the recovery period, RR period gradually extended, and also extensi on of the QT interval.2.By measuring treadmill exercise test before exercise starts;90times per minute in the movement,120times per minute,fast hean rate；motor after th e recovery period is1minute,3minutes of the heart rate.QTc values:positive grou(myocardial ischemia group:454.78±27.156；456.39±23.888；475.36±22.969；467.76±28.005；466.72±22.922；461.49±18.137)and suspected positive gro up(suspected myocardial ischemia group:458.18±34.10；463.704±23.357；467.56±23.593；463.33±25.318；458.33±22.228；458.64±23.787)and negative(control group:438.81±23.259；445.43±16.739；452.64±15.843；445.22±24.269；441.49±20.245；441.79±24.780)compared to QT values significantly extend,P<0.05,a statistically significant difference.3.Coronary disease patient compares with the non-coronary disease QTc v alue.Before exercise starts；90times per minute in the movement,120times p er minute,fast heart rate;motor after the recovery period is1minute,3minu tes of the heart rate.the QTc values:negative group(451.25±37.634；450.93±16.421；457.43±16.113;448.75±20.530;446.75±23.685；442.50±28.801),positive group(485.56±31.667；475.22±23.392；485.33±27.776；476.67±24.495；470.00±25.981；474.44±27.889).the QTc values:significantl y extend,,P<0.05,a statistically significant difference.4.Patients with adverse events and adverse events did not occur compared to before exercise starts;90times per minute in the movement,120times pe r minute,fast heart rate;motor after the recovery period is1minute,3minut es of the heart rate.the QTc values:Patients with adverse events did not occur group(445.59±27.749；450.54±17.838；459.22±21.865；452.57±27.189；449.93±23.742；449.49±25.072),Patients with adverse events group(482.12±37.396；484.64±18.508；484.64±18.274；476.06±23.310;468.48±2O.019；475.15±22.517).the QTc values:significantly extend,P<0.05,a statistical1y significant difference.And draws the subject operating characteristics(ROC) curve maximum area under the curve of0.751,corresponds to the restoration period of3minutes,covering an area of confidence interval f.or the standard error SE0.051,95％(0.651,0.851),p-value of0.000,the best diagnostic value corresponds to465ms.At this time the sensitivity and specificity of66.7%and75%.Conclusion1.Normal person QT the time reduces along with the ventricle rate increas e, the normal person heteropolar bond reserve function is good.2.myocardial ischemia patient QT interval not to reduce along with the ve ntricle rate change, myocardial ischemia patient repolarization reserve is bad3.patient with coronary heart disease repolarization reserve is reduced.4.Follow-up of adverse events in patients with bipolar reserves dysfunction. Take treadmill exercise test recovery for3minutes, QTc value of0.465as th e best diagnostic boundary value.