ĐẶC ĐIỂM TỔN THƯƠNG ĐỘNG MẠCH VÀNH Ở BN BỊ RỐI LOẠN NHỊP THẤT TRÊN 45 TUỔI

Abstract

Objective: To study the characteristics of coronary artery lesion in patients with ventricular arrhythmias older than 45 years old. Subjects and methods: 101 patients were diagnosed ventricular arrhythmias, classified ≥ Lown 2, at Nghe An Friendship General Hospital. The patient had coronary angiography (CAD) via catheters and the results were evaluated by QCA method. Results: 101 patients had ventricular arrhythmias ≥ Lown 2, had coronary angiography through catheters, 60 patients had coronary artery lesions, accounting for 55,4%; coronary artery stenosis ≥ 50% is 5,9%; stenosis 50 - 70% is 13,9% and stenosis ≥ 90% is 16,8%. Coronary artery lesion of one branch accounted for 34,7%; two branches is 12,9% and three branches is 7,9%. Coronary artery stenosis ≥ 70% of the vessel lumen are accounting for 30,7%; in which the left anterior descending artery (LAD) accounts for 20,8%, the left circumflex (LCx) coronary arteries is 7,0%, the right coronary artery is 14,8% and the left main (LM) coronary artery is 2%. Coronary artery stenosis ≥ 70% in the group ≥ 60 years old accounted for 39,7% was higher than 3,5 times (95% CI: 1,3 – 9,6) compared with the group  45 ≤ age < 60 years old was 15,8% (p < 0,01); the group ≤ average cardiovascular disease  was 0.21 times (95% CI: 0,08 – 0,59 compared with the group ≥ high cardiovascular disease according to the SCORE 2 index (p<0,01); The ventricular arrhythmia (VA) group orgin from left ventricle accounted for 44,1%, that was higher than 2,52 times (95% CI: 1,04 – 6,06) compared with the VA group orgin from right ventricles (p<0,05). The rate of coronary artery stenosis ≥ 70% at the locations orgining VAs: right ventricular outflow tract (RVOT) is 13,8%, left ventricular outflow tract (LVOT) is 36% and other locations are 22,2% (p < 0.01). Conclusions: The rate of coronary artery lesion in patients with ventricular arrhythmias was 55,4%; in which coronary artery stenosis ≥ 70% accounted for 29,7%, the lesion of one coronary artery branch accounted for 34,7%, two  branches is 12,9% and three branches is 7,9%. The rate of coronary artery lesion increases in group with high risk of cardiovascular disease. Ventricular arrhythmias orgins from RVOT and LVOT coexists with coronary artery disease, the VA orgining from other locations is related signification to the dgree of coronary artery lesion.