中文摘要：

目的 探讨老年心肌梗死后慢性心力衰竭（CHF）患者心室结构-心电重构与心律失常的关系。方法 收集老年心肌梗死后CHF患者55例[心功能（NYHA分级）：Ⅱ级23例，Ⅲ级15例，Ⅳ级17例]及心肌梗死后心功能（NYHA）Ⅰ级患者30例，采用超声心动图，标准12导联心电图及24小时动态心电图检测其心室腔大小，QT间期，校正QT间期（QTc）及心律失常。结果 与心功能I级组比较，CHF组心室腔显著扩大[CHF组：左室舒张末直径（LVEDD）（57±8）mm，左室收缩末直径（LVESD）（45±8）mm；心功能Ⅰ级组：LVEDD（45±5）mm，LVESD（31±5）mm，P〈0．05]。两组间心室复极指标无显著差异[CHF组：QT（0．41±0．07）s，QTc（0．44±0．06）s；心功能Ⅰ级组：QT（0．41±0．04）s，QTc（0．44±0．04）s]。两组间室性心律失常亦无显著差异[CHF组：室性早搏（VPB）（219±598）次／24h；心功能Ⅰ级组：VPB（345±504）次／24h]。结论 老年心肌梗死后CHF时，心室结构重构显著，心 室腔显著扩大，但在本研究中心室结构重构未见引起显著心电重构，心室复极延长及室性心律失常未见显著增加。

英文摘要：

AIM To investigate the relation between ventricular structural electrocardiological remodeling and ventricular arrhythmia in elderly patients with chronic congestive heart failure （CHF） secondary to old myocardial infarction. METHODS Fifty-five elderly patients with CHF secondary to old myocardial infarction （23 in cardiac function class Ⅱ, 15 in class Ⅲ, 17 in class Ⅳ, NYHA ） and in 30 agematched elderly patients with cardiac function class Ⅰ （NYHA） secondary to old myocardial infarction were included in this study. Their ventricular chamber sizes, QT, QTc intervals and the ventricular arrhythmia were assessed respectively with echocardiography, standard 12-lead electrocardiography and 24- hour Hoher recordings. RESULTS The ventricular chamber sizes were significantly larger in the elderly patients with CHF than those in cardiac function class I group [ CHF group： left ventricular end diastolic diameter （LVEDD） （57 ± 8 ） ram; left ventricular end systolic diameter （LVESD） （45 ± 8 ） mm vs. cardiac function class Ⅰgroup： LVEDD （45 ± 5 ）mm; LVESD （ 31± 5 ） mm, P 〈 0.05, respectively ]. However, there was no difference in ventricular repolarization indices between the two groups [ CHF group： QT （ 0.41±0.07） s; QTc （ 0.44±0.06） s vs. cardiac function class Ⅰ group： QT （0.41 ± 0.04 ） s, QTc （0.44 ± 0.04） s, respectively ]. The ventricular arrhythmogenesis was also not found to be significantly higher in the elderly patients with CHF than those in cardiac function class Ⅰ group [ CHF group： ventricular premature beat （VPB） （219 ±598）1/24 h vs. cardiac function class Ⅰ group： VPB（345 ± 504）1/24 h ]. CONCLUSION The ventricular structural remodeling enlargement is significant in elderly patients with CHF secondary to old myocardial infarction. However, the ventricular structural re-modeling enlargement does not cause significant prolongation of the ventricular repolarization and the increase of the ventricular arrhythmo