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心率振荡的评估和临床预后价值 被引量：2

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摘要 缺血性心脏病患者进行危险分层的关键是识别出高危患者,从而积极预防包括死亡在内的心血管事件.为此,大量临床研究共同探讨对心肌梗死(MI)后高危患者的识别,并取得一些成果.近年来,多项指标被用来预测MI后患者的长期预后,如左室功能不全、频发室早、非持续性室性心动过速、心率变异、平均心率、T波改变、QT离散度.但这些指标的阳性预测值低,假阳性率高[1～5],甚至联合几项预测因子的阳性预测值也很少超过30%[6].最近,Schimdt等[7]等提出一项新指标,即心率振荡(Heart Rate Turbulence,HRT),并认为异常的HRT值是MI后患者死亡的强烈的独立预测因子.
作者 杨小燕 顼志敏
机构地区 首都医科大学附属朝阳医院 中国医学科学院阜外心血管病医院
出处 《中国医药导刊》 2004年第4期267-269,共3页 Chinese Journal of Medicinal Guide
关键词 心率振荡 预后 缺血性心脏病 心肌病
分类号 R542.22 [医药卫生—心血管疾病]
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参考文献38

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  • 2Huikuri HV, Lindgren K, Tapanainen J, et al. Prognostic power of traditional and new heart rate variability indices in patients with optimized therapy after myocardial infarction. Results ofa prospective study. Circulation,2001; 104(Suppl Ⅱ) :637, 3014(a
  • 3Sestito A, Valsecchi S, Infusino F, et al. Differences in heart rate turbulence between patients with coronary artery disease and patients with ventricular arrhythmias but structurally normal hearts. The American Journal of Cardiology,2004;93:1114 ～ 1118
  • 4Yap YG, Camm A J, Schmidt G, et al. Novel heart rate turbulence predicts arrhythmic mortality in postmyocardial infarction patients with left ventricular dysfunction - EMIAT substudy. J Am Coll Cardiol, 2001; 37 ( Suppl A ): 1A ～ 648A, 1173 ～1181 (abstr
  • 5Berkowitsch A, Guettler N, Schulte B, et al. Heart - rate turbulence slope after paced premature ventricular beats as a predictor for the recurrence of ventricular tachyarrhythmias: A study in defibrillator patients. Circulation, 2000; 102 (Suppl):Ⅱ - 52
  • 6Yap YG, Camm AJ, Schmidt G, et al. Heart rate turbulence is influenced by heart rate, age, LVEF, NYHA class, diabetes, drugs and frequency of ventricular ectopics in patients after acute myocardial infarction - EMIAT substudy. J Am Coll Cardiol,2001;37(Su
  • 7L Ceri Davies, Darrel P Francis, Piotr Ponikowski, et al. Relation of Heart Rate and Blood Preasure Turbulence Following Premature Ventricular Complexes to Baroreflex Sensitivity in Chronic Congestive Heart Failure. Am J Cardiol, 2001; 87:737 ～ 742
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  • 10GhuranA, Reid F, La Rovere M, et al. Heart rate turbulence based predictors of fatal and non - fatal cardiac arrest: The autonomic tone and reflexes after myocardial infarction substudy. Am J Cardiol,2002;89:184～ 190

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中国医药导刊
2004年 第4期

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