摘要
Abstract
Objective To analyze the change characteristics of echocardiographic parameters and resting electrocardiogram indicators and their predictive value for poor prognosis in elderly patients with chronic heart failure(CHF).Methods A total of 150 elderly CHF patients admitted to Guiyang Public Health Clinical Center from January 2023 to October 2025 were retrospectively enrolled.Echocardiographic parameters(LVEF,LVEDD,LVESD,SV)and resting electrocardiogram indicators(ST-T changes,QRS duration)were compared among patients with different NYHA cardiac function grades.Spearman correlation analysis was applied to examine the correlation between each indicator and cardiac function grade.All patients were followed up for 6 months after discharge and divided into the poor prognosis group and the favorable prognosis group according to clinical outcomes.The differences in clinical indicators were compared between the two groups.Binary Logistic regression analysis was performed to identify the independent influencing factors of poor prognosis,and ROC curves were plotted to evaluate the predictive efficacy of single and combined detection of each indicator for poor prognosis.Results With the elevation of NYHA cardiac function grade,patients presented with gradually decreased LVEF and SV,as well as progressively increased LVEDD,LVESD,ST-T change rate and QRS duration(P<0.05).Spearman correlation analysis showed that NYHA cardiac function grade was positively correlated with LVEDD,LVESD,ST-T change rate and QRS duration(r=0.463,0.506,0.469,0.429,all P<0.001),and negatively correlated with LVEF and SV(r=-0.587,-0.429,all P<0.001).A total of 44 patients developed poor prognosis during the 6-month follow-up.The poor prognosis group had lower LVEF and SV,and higher LVEDD,LVESD,ST-T change rate and QRS duration than the favorable prognosis group(P<0.05).Binary Logistic regression analysis indicated that decreased LVEF,enlarged LVEDD,increased LVESD,reduced SV,presence of ST-T changes and prolonged QRS duration were all independent influencing factors for poor prognosis in elderly CHF patients(P<0.05).ROC curve analysis demonstrated that each single indicator had certain predictive value for poor prognosis,among which LVESD achieved the highest predictive efficacy(AUC=0.819).The AUC of combined prediction with echocardiographic parameters and resting electrocardiogram indicators was 0.959,which was significantly higher than that of any single indicator(P<0.001).Conclusions Echocardiographic parameters and resting electrocardiogram indicators in elderly CHF patients present regular changes along with the deterioration of cardiac function.Combined detection of the two types of indicators can effectively improve the predictive value for poor prognosis,and provide reference for clinical risk stratification and intervention decision-making.关键词
老年慢性心力衰竭/超声心动图/静息心电图/变化特征/预后不良Key words
Elderly chronic heart failure/Echocardiography/Resting electrocardiogram/Change characteristic/Poor prognosis分类
医药卫生
