Correlation between quantitative parameters of electrocardiogram and cardiac function in patients with reduced ejection fraction heart failure and its early warning role in the occurrence of major cardiovascular adverse events

WANG Ping-zheng; CAO Zhen-hua; WANG Shu-ping

doi:10.3969/j.issn.1672-5301.2024.05.008

Abstract：Objective To investigate the correlation between quantitative ECG parameters and cardiac function in patients with reduced ejection fraction heart failure(HFrEF)and the early warning role for the major adverse cardiac events(MACE).Methods A total of 105 HFrEF patients with complete follow-up data admitted to Qingdao Jiaozhou Central Hospital from September 2021 to June 2023 were selected as the study objects.According to whether MACE occurred within 12 months,the patients were divided into the MACE group and non-MACE group.Ecg monitoring was performed after admission.The clinical data and quantitative parameters of electrocardiogram[T peak interval(Tp-Te),Tp-Te/√RR,corrected Q-T interval dispersion(QTcd),QRS wave history(QRsd)]of the two groups were compared,and the correlation between quantitative parameters of electrocardiogram and left ventricular ejection fraction(LVEF)was analyzed.The related influencing factors of MACE in HFrEF patients and the predictive value of quantitative ECG parameters for MACE in HFrEF patients were analyzed.Results Compared with the no MACE group,the NYHA cardiac function grade was higher but LVEF was lower in the MACE group(P<0.05).Tp-Te,Tp-Te/√RR,QTcd and QRSd in MACE group were higher than those in non-MACE group[(115.00±16.84)ms vs.(99.52±13.47)ms,(4.18±0.75)vs.(3.79±0.66),(110.45±12.76)ms vs.(95.38±18.45)ms,(139.67±10.51)ms vs.(117.34±12.49)ms,P<0.05].Tp-Te,Tp-Te/√RR,QTcd,QRSd were negatively correlated with LVEF(r=-0.787,-0.713,-0.754,-0.770,P<0.05).Multivariate logistic regression analysis showed that Tp-Te,Tp-Te/√RR,QTcd and QRSd were the independent risk factors for MACE in HFrEF patients(P<0.05).Among the Tp-Te,Tp-Te/√RR,QTcd and QRSd,QTcd had the largest AUC in predicting MACE in HFrEF patients,and Tp-Te had the largest specificity in predicting MACE in HFrEF patients.The AUC of MACE in HFrEF patients predicted by the combination of QTcd and Tp-Te was 0.925,which was larger than that of QTcd alone,of which the sensitivity was 85.71%and the specificity was 82.86%(P<0.05).Conclusion The quantitative parameters of ECG are closely related to the cardiac function of HFrEF patients,which would provide a reference for early clinical prediction of MACE so as to make the targeted intervention plans and reduce the risk of MACE.