| BackgroundDifferent period between lead on QT intervals had been found, but for a long time,it has been attributed to measuring error caused by the asynchronous records. In 1985, Campbell and Cowan, after using the synchronization record of 12 lead, instead of a regular phenomenon, and put forward the discrete degree of QT dispersion( QTd).QTd is the maximum inter-lead variation between the longest and shortest QT intervals recorded in the standard 12-lead electrocardiogram(ECG). Day,in 1990, found that increased QTd closely associated with ventricular arrhythmias and sudden death, and put forward the QTd can be used as a prediction index of malignant ventricular arrhythmia and sudden death. QTd represents the regional heterogeneity of ventricular repolarization duration in the 3-dimensional structure of ventricular myocardium.Coronary chronic total occlusions(CTO) are defined as an occluded coronary segment with thrombolysis in myocardial infarction flow 0 for ?3 months duration.CTO lesions is a kind of common complex coronary artery lesions, detection of coronary angiography of coronary artery stenosis in patients with obviously 20% ~ 30%, with the development of the operation technology and equipment, in recent years, the CTO patients received PCI increase gradually, but only 20% of all cases of PCI, hence, there are still some controversial CTO lesions PCI choice. Most CTO lesions are synthetic or reverse the collateral circulation, keep the distal occlusion segment certain blood supply, but, even if sufficient collateral circulation based on the function also is only equivalent to 90% of narrow blood vessels, which is in a state of ischemia of myocardium area may damage ventricular muscle complex. It has been previoudly demonstrated by many studies was presented as an increase in QTd and the QTd was decreased following successful revascularization. Percutaneous recanalization of chronic total occlusion can decrease QTd, but the report about effect of different chronic occlusion lesions on QTd after PCI is less. This experiment aims to compare effect of different coronary artery CTO lesions after PCI on QTd, to provide more evidence for percutaneous recanalization of CTOs. ObjectiveTo compare effect of different coronary artery CTO lesions after PCI on QTd MethodsWe studied 153 patients with angiographically at least 1 major coronary arteries CTO(the left anterior descending branch, cyclotron branch and right coronary artery) who had admitted to the department of cardiology of the First Affiliated Hospital of Zhengzhou university, including 52 cases of LAD-CTO, 34 cases of LCX-CTO, 67 cases of RCA-CTO.For each patient, before and after PCI, using the standard 12-lead ECG collects clinical data. Using SPSS19.0 statistical software for statistical analysis of the data of the three groups. Results1. There was no statistical difference to the baseline data of the three groups(P>0.05);2. Percutaneous recanalization of chronic total occlusion of the three groups can decrease QTd, QTcd(LAD-CTO 43.90±4.61 vs.56.40±4.75 P<0.001,45.46±4.87 vs.58.40±5.13 P < 0.001; LCX-CTO 40.35±3.26 vs.49.06±4.57 P < 0.001,42.29±3.22 vs.51.42±4.65 P<0.001;RCA-CTO 43.73±4.13 vs.53.97±4.95 P<0.001, 44.74±4.36 vs.55.22±5.28 P < 0.001), the difference was statistically significant(P<0.05);3. The QTd and QTcd difference before and after PCI of three groups are: LAD-CTO(12.50 + 2.55)ms,(12.95-2.68) ms; LCX- CTO(8.71 + 2.31)ms,(9.13-2.43) ms; RCA- CTO(10.24 + 1.81)ms,(10.48-1.89) ms. The difference between each two groups was statistical significance(P < 0.05). ConclusionPercutaneous recanalization of chronic total occlusion can decrease QTd?QTcd, the degree of reduce from large to small is LAD-CTO,RCA-CTO,LCX-CTO. It is likely that percutaneous recanalization of CTO can get more clinical outcomes and is 0f greater importance on preventing ventricular arrhythmia. |
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