S-Tp、S-Te间期与射血分数改善的心力衰竭的相关性分析

doi:10.3969/j.issn.1004-583X.2025.10.003

摘要/Abstract

摘要：

目的探讨心电图S波谷至T波峰(S-Tp)间期、S波谷至T波末(S-Te)间期与射血分数改善的心力衰竭(HFrecEF)的相关性。方法纳入2022年6月-2024年6月期间在聊城市第三人民医院住院的心力衰竭(心衰)患者,完善超声心动图、心电图及常规抽血化验。根据左室射血分数(LVEF)选取射血分数降低的心衰(HFrEF,入院时LVEF≤40%)。完成3月、6月的随访,根据纳入患者出院6月后的超声心动图所测定的LVEF,选出射血分数改善的心衰组(HFrecEF,入院时LVEF≤40%,复查时LVEF>40%且LVEF上升幅度≥10%),余患者即为HFrEF组。采用独立样本t检验分析组间差异,多元线性回归分析评价 S-Tp、S-Te间期与心衰相关标记物的关系。结果本研究最终纳入患者180例,HFrecEF组48例(26.67%),HFrEF组132例(73.33%)。HFrecEF组S-Tp、S-Te间期明显短于HFrEF组,分别为(0.22±0.02) ms vs (0.29±0.05) ms,(0.31±0.05) ms vs (0.38±0.05) ms,差异有统计学意义(P均<0.05)。另外,HFrecEF组年龄偏小,吸烟、饮酒比例低,血清N-末端B型利钠肽前体(NT-proBNP)、低密度脂蛋白高于HFrecEF组,胱抑素C、尿素氮、肌酐水平明显低于HFrEF组,S-Tp、S-Te间期与心衰患者NT-proBNP、胱抑素C水平均存在正相关,差异有统计学意义(P均<0.05)。结论 S-Tp、S-Te间期与HFrecEF存在相关性,较短的S-Tp、S-Te间期是心衰患者治疗后LVEF改善的独立预测因子。

关键词: 心力衰竭, S-Tp间期, S-Te间期, 每搏输出量

Abstract:

Objective To examine the correlation between the S-Tp (interval from the nadir of the S wave to the peak of the T wave) and S-Te (interval from the nadir of the S wave to the end of the T wave) on surface electrocardiography with heart failure with recovered ejection fraction (HFrecEF). Methods Consecutive patients hospitalized with heart failure at the Third People's Hospital in Liaocheng from June 2022 to June 2024 were enrolled. All patients underwent echocardiography, electrocardiography, and routine laboratory testing at baseline. The heart failure with reduced ejection fraction (HFrEF) was defined as left ventricular ejection fraction (LVEF) ≤40% at the index admission. After followup at 3 and 6 months, patients were classified at 6 months as having HFrecEF (baseline LVEF ≤40%, followup LVEF >40%, and an absolute increase ≥10%) or persistent HFrEF (all others). Betweengroup differences were assessed using independentsamples t tests. Multivariable linear regression was used to evaluate associations between S-Tp, S-Te, and heart failure-related biomarkers. Results A total of 180 patients were included; 48 (26.7%) were classified as HFrecEF and 132 (73.3%) as persistent HFrEF. Mean S-Tp and S-Te intervals were significantly shorter in HFrecEF than in persistent HFrEF (S-Tp: 0.22±0.02 ms vs 0.29±0.05 ms; S-Te: 0.31±0.05 ms vs 0.38±0.05 ms; all P<0.05). In addition, the HFrecEF group was younger and had lower rates of smoking and alcohol consumption than the HFrEF group. Serum levels of Nterminal pro-Btype natriuretic peptide (NTproBNP), low-density lipoprotein were higher than HFrecEF, cystatin C, blood urea nitrogen, and creatinine were also significantly lower in HFrecEF. In multivariable analyses, both S-Tp and S-Te were positively correlated with NTproBNP and cystatin C (all P<0.05). Conclusion S-Tp and S-Te intervals are associated with HFrecEF after treatment and may serve as independent predictors of LVEF improvement in patients initially presenting with HFrEF.

Key words: heart failure, S-Tp interval, S-Te interval, stroke volume

中图分类号:

R541.62

刘三龙, 张文龙, 刘英, 杜贵芳, 孟昭斌. S-Tp、S-Te间期与射血分数改善的心力衰竭的相关性分析[J]. 临床荟萃, 2025, 40(10): 893-896.

Liu Sanlong, Zhang Wenlong, Liu Ying, Du Guifang, Meng Zhaobin. Correlation analysis of S-Tp and S-Te intervals with heart failure with recovered ejection fraction[J]. Clinical Focus, 2025, 40(10): 893-896.

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链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2025.10.003

https://www.lchc.cn/CN/Y2025/V40/I10/893

图/表 3

参考文献 13

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项目	射血分数降低组(n=132)	射血分数改善组(n=48)	t/χ²值	P值
年龄(岁)	70.80±9.89	59.21±8.41	-7.793	0.001
男性[例(%)]	42(31.82)	18(37.50)	0.511	0.475
吸烟史[例(%)]	41(31.06)	7(14.58)	-5.278	0.022
饮酒史[例(%)]	42(31.82)	6(12.50)	-6.717	0.010
冠心病[例(%)]	82(62.12)	30(62.5)	0.002	0.963
高血压病[例(%)]	84(63.64)	28(58.33)	0.421	0.516
心房颤动[例(%)]	42(31.82)	12(36.36)	0.779	0.377
Tp-Te(ms)	0.09±0.04	0.08±0.02	-1.596	0.114
STp间期(ms)	0.29±0.05	0.22±0.02	-7.953	0.001
STe间期(ms)	0.38±0.05	0.31±0.05	-8.250	0.001
肌钙蛋白I(μg/L)	0.17±0.57	0.09±0.07	-1.596	0.114
NT-proBNP(ng/L)	6 289.92±2890.29	9 506.04±7050.38	-4.233	0.001
血红蛋白(g/L)	133.96±17.93	136.17±18.28	0.651	0.518
总胆固醇(mmol/L)	4.26±1.03	4.45±0.70	1.356	0.179
LDL(mmol/L)	2.74±0.93	3.06±0.89	2.078	0.042
总胆红素(μmol/L)	23.85±10.81	28.48±13.68	1.883	0.066
胱抑素C(mg/L)	1.05±0.64	0.78±0.61	-2.516	0.014
尿素氮(mmol/L)	8.08±4.48	5.55±3.63	-3.557	0.001
肌酐(μmol/L)	89.27±27.69	76.57±10.37	-4.463	0.001
Hcy(μmol/L)	17.21±11.71	15.10±4.65	-1.602	0.111

项目	射血分数降低组(n=132)	射血分数改善组(n=48)	t/χ²值	P值
年龄(岁)	70.80±9.89	59.21±8.41	-7.793	0.001
男性[例(%)]	42(31.82)	18(37.50)	0.511	0.475
吸烟史[例(%)]	41(31.06)	7(14.58)	-5.278	0.022
饮酒史[例(%)]	42(31.82)	6(12.50)	-6.717	0.010
冠心病[例(%)]	82(62.12)	30(62.5)	0.002	0.963
高血压病[例(%)]	84(63.64)	28(58.33)	0.421	0.516
心房颤动[例(%)]	42(31.82)	12(36.36)	0.779	0.377
Tp-Te(ms)	0.09±0.04	0.08±0.02	-1.596	0.114
STp间期(ms)	0.29±0.05	0.22±0.02	-7.953	0.001
STe间期(ms)	0.38±0.05	0.31±0.05	-8.250	0.001
肌钙蛋白I(μg/L)	0.17±0.57	0.09±0.07	-1.596	0.114
NT-proBNP(ng/L)	6 289.92±2890.29	9 506.04±7050.38	-4.233	0.001
血红蛋白(g/L)	133.96±17.93	136.17±18.28	0.651	0.518
总胆固醇(mmol/L)	4.26±1.03	4.45±0.70	1.356	0.179
LDL(mmol/L)	2.74±0.93	3.06±0.89	2.078	0.042
总胆红素(μmol/L)	23.85±10.81	28.48±13.68	1.883	0.066
胱抑素C(mg/L)	1.05±0.64	0.78±0.61	-2.516	0.014
尿素氮(mmol/L)	8.08±4.48	5.55±3.63	-3.557	0.001
肌酐(μmol/L)	89.27±27.69	76.57±10.37	-4.463	0.001
Hcy(μmol/L)	17.21±11.71	15.10±4.65	-1.602	0.111

指标	标准误	t值	P值	R值	β值	95%CI
NT-proBNP	0.000	12.961	0.001	0.696	0.000	0.000~0.000
低密度脂蛋白	0.003	-2.065	0.004	-0.114	-0.007	-0.013~0.000
胱抑素C	0.006	3.620	0.001	0.299	0.023	0.010~0.035
尿素氮	0.001	2.505	0.013	0.192	0.001	0.001~0.004
肌酐	0.000	-0.784	0.434	-0.058	0.000	0.000~0.001

指标	标准误	t值	P值	R值	β值	95%CI
NT-proBNP	0.000	12.961	0.001	0.696	0.000	0.000~0.000
低密度脂蛋白	0.003	-2.065	0.004	-0.114	-0.007	-0.013~0.000
胱抑素C	0.006	3.620	0.001	0.299	0.023	0.010~0.035
尿素氮	0.001	2.505	0.013	0.192	0.001	0.001~0.004
肌酐	0.000	-0.784	0.434	-0.058	0.000	0.000~0.001

指标	标准误	t值	P值	R值	β值	95%CI
NT-proBNP	0.000	10.952	0.001	0.615	0.000	0.000~0.000
低密度脂蛋白	0.004	1.838	0.068	0.107	0.007	0.000~0.014
胱抑素C	0.008	4.353	0.001	0.008	0.033	0.018~0.048
尿素氮	0.001	0.691	0.491	0.055	0.001	-0.001~0.003
肌酐	0.000	2.313	0.022	0.000	0.000	0.000~0.001