| Objective:This study was to explore prognostic value of Tp-e Interval ? Tp-e/QT in ST-segment elevation myocardial infarction patients with spontaneous reperfusion of infarct-related artery undergoing percutaneous coronary intervention,to explore the formation mechanism of Tp-e on ECG,which represents transmural dispersion or global heart dispersion of repolarization.Methods:The study selected 288 STEMI patients in the people's hospital of Zhengzhou University from October 2014 to October 2016.Patients with TIMI(Thrombolysis In Myocardial Infarction)0 ?1 degree of infarct-related artery before PCI were Occlusion Group,while patients of TIMI 2?3 degree of Infarct-related artery before PCI were Spontaneous-reperfusion Group.The age and gender of Occlusion Group were not different compared with Spontaneous-reperfusion Group.12 leads(if necessary 18 leads)ECGs were made in all myocardial infarction patients during bedside ECG monitoring.Tp-e interval and Tp-e/QT ratio were measured and calculated 1hour(1h)before PCI and 1 hour(1h)?1 week(1w)after PCI in STEMI patients.Malignant arrhythmia events(MAE)were followed up 2 week with bedside ECG monitoring during their hospitalization.Results :(1)Compared with Occlusion Group,the hypertension(6.3%:46.7%;P<0.001)?diabetes(3.2%:33.3%;P<0.001)?cerebrovascular disease(4.8%:14.7%;P=0.012)?smoking history(7.9%:64.0%;P<0.001)?drinking history(9.5%:52.0%;P<0.001)?high serum cholesterol(3.7±0.8mmol/L:5.7±0.6mmol/L;P=0.021)and white blood cell(5.1±1.310^9/L : 11.4±2.6 10^9/L;P < 0.001)of Spontaneous-reperfusion Group were significant difference(P<0.05).(2)Tp-ec and Tp-e/QT ratio at 1 hour after and before PCI?1 week and 1 hour after PCI in Spontaneous-reperfusion Group and Occlusion Group were significantly different(P<0.05).Tp-ec?Tp-e/QT ratio between Spontaneous-reperfusion Group and Occlusion Group at 1 hour before PCI?1 hour?1week after PCI were significant difference(P<0.05).(3)When setting the corrected Tp-e interval 120 ms and Tp-e/QT ratio 0.30 at 1 hour before PCI as the cutoff point in Spontaneous-reperfusion Group,the occurrence of MAE were significant different between the two groups(P<0.05).(4)Multivariable logistic analysis of regression showed that concurrent diabetes(OR=5.200,95%CI:2.003-13.498;P=0.001)?smoking history(OR=11.714,95%CI:3.215-42.677;P<0.001)?serum cholesterol(OR=5.029,95%CI: 1.867-13.545;P=0.001)were related risk factors of the occurrence of MAE in STEMI patients undergoing PCI.After related risk factors were adjusted by multivariable logistic analysis of regression,No spontaneous reperfusion(OR=0.211,95%CI:0.045-0.976;P=0.047)of STEMI patients undergoing PCI was an independent risk factor of the occurrence of MAE.Conclusion:1?After related risk factors of concurrent diabetes?smoking history?serum cholesterol are adjusted by multivariable logistic analysis of regression,SR of infarct-related artery with STEMI patients before PCI is a protective factor of MAE occurrence.2?Tp-e interval and Tp-e/QT ratio of STEMI patients with SR before PCI are related with MAE occurrence.3?Tp-e can indirectly reflect transmural dispersion of repolarization. |
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