The Clinical Analysis Of Dynamic Electrocardiogram(DCG) In Patients With Chronic Cor Pulmonale

Objective: To study arrhythmia, myocardial ischemia, heart rate variability, heart rate turbulence with DCG technology in patients with chronic cor pulmonale.Reveal the rule of waveform evolution of cor pulmonale and provide valuable reference data for diagnosing, treatment and early warning.Methods: 120 patients were collected from respiratory department who was diagnosed with chronic cor pulmonale. According to the symptom, the results of doppler echocardiography and electrocardiogram(ECG) examination, patients were divided into group B and group C. Group B was composed of 60 chronic cor pulmonale patients in cardiac compensation period, and group C was composed of 60 chronic cor pulmonale patients in cardiac decompensation period. 60 patients in other department were collected to form the control group, which was called group A. Patients in group A haved not been associated with respiratory and cardiovascular disease. There were no statistically significant difference between the groups in terms of gender, age, height and weight(P>0.05). 24 h dynamic electrocardiogram(Holter) analysis system produced by Cardio Scan II software technology company in DMS company was used to monitor the ECG datas from 8:30 the day after in hospital and were removed the next day. The ECG datas were continuously monitored for 24 h. Detailed records were done during the test and patients were telled to record the living activity, the heart discomfort symptoms etc. so that the professional physicians could analyze and compare accurately. The concrete analysis include ST-T changes(include the incidence of ST depression and ST elevation, the magnitude and duration of ST shifting) the incidence of arrhythmia, heart rate turbulence, deceleration capacity and heart rate variability.Results:1 The incidence, magnitude and duration of ST shifting in group B and C were significantly higher than group A(P<0.05, P<0.01). The incidence, magnitude and duration of ST depression and the incidence, magnitude of ST elevation in group C were significantly higher than group B(P<0.05, P<0.01)2 The incidence of SB、VPB、VT in group C were significantly higher than group A(P<0.05). The incidence of VPB、VT、AF in group C were significantly higher than group B(P<0.05).3 The indexes of TD and TO in group B and group C were significantly higher than group A(P<0.05, P<0.01), and the index of TS in group B and group C were significantly lower than group A(P<0.05). The indexes of TD and TO in group C were significantly higher than group B(P<0.05), and the index of TS in group C were significantly lower than group B(P<0.05).4 The indexes of SDNN and SDANN in group B and group C were significantly lower than group A(P<0.05, P<0.01), and the indexe of r MSSD in group C was significantly lower than group A(P<0.05). The indexes of SDNN and SDANN in group C were significantly lower than group B(P<0.05).5 The indexes of DC, LF and HF in group B and group C were significantly lower than group A(P<0.05, P<0.01). The indexes of DC, LF and HF in group C were significantly lower than group B(P<0.05, P<0.01).Conclusion: The relevant indexes of DCG of arrhythmia, myocardial ischemia, heart rate turbulence, deceleration capacity of rate and heart rate variability in the patients with chronic cor pulmonale have important reference and guiding value to the identification of compensatory and decompensatory phase of chronic Cor pulmonale. They also have great significance to the determine and treatment of chronic cor pulmonale.