论文部分内容阅读
目的观察心率震荡(HRT)的新指标-动态心率震荡(TD)在慢性心力衰竭患者中的变化及HRT各指标与传统高危预测指标的相关性。方法选择55例慢性心衰患者(心衰组)和32例非器质性心脏病患者(对照组)接受24h动态心电图检查,分别计算HRT的震荡初始(TO)、震荡斜率(TS)、动态心率震荡(TD)及心率变异性时域指标SDNN、平均心率及左室射血分数(LVEF),比较心衰组与对照组HRT各指标的差异,及其与传统高危预测指标的相关性。结果心衰组TO明显高于对照组,TS和TD低于对照组(p<0.05);心衰组各指标相关性分析结果显示,年龄和平均心率与TO正相关,与TS负相关;TO与SDNN、LVEF呈负相关,TS与SDNN、LVEF呈正相关(p<0.05);TO与TS负相关(p=0.004);TD与平均心率、SDNN、LVEF均无显著相关性(p>0.05)。结论心衰组HRT明显减弱,尤以TD和TS变化显著;新指标TD在测量时不受平均心率等因素影响,提示与TO、TS相比,TD可提供更客观预测价值,HRT可作为慢性心衰患者预后评估又一项新的高效预测指标。
Objective To observe the changes of heart rate turbulence (HRT), dynamic heart rate turbulence (TD) in patients with chronic heart failure and the correlation between HRT indexes and traditional high-risk predictors. Methods Fifty-five patients with CHF (heart failure) and 32 patients with non-structural heart disease (control group) underwent 24h Holter monitoring. The TOO, TS, Heart rate turbulence (TD) and heart rate variability time domain index SDNN, mean heart rate and left ventricular ejection fraction (LVEF), heart failure compared with the control group HRT each index differences, and its correlation with the traditional high-risk predictors. Results The heart failure group TO was significantly higher than the control group, TS and TD were lower than the control group (p <0.05); Correlation analysis showed that the age and average heart rate were positively correlated with TO and negatively correlated with TS; TO (P <0.05). There was a negative correlation between TO and TS (p = 0.004). There was no significant correlation between TD and mean heart rate, SDNN and LVEF (p> 0.05) . Conclusion The HRT of heart failure group is obviously weakened, especially TD and TS. The new index TD is not affected by the average heart rate and other factors, suggesting that TD can provide more objective predictive value than TO and TS, and HRT can be used as chronic Heart failure patients prognosis assessment is another new high-performance predictors.