不同人格类型对心脏电生理参数及心律失常发生的影响

Effects of personality types on cardiac electrophysiological parameters and arrhythmias

目的研究不同人格类型对心脏电生理参数及心律失常发生的影响。方法以Eysenck人格问卷(EPQ)对97例行射频消融术的阵发性室上性心动过速患者进行人格测试,区分为内向稳定、内向不稳定、外向稳定和外向不稳定4种人格类型。采用同步12导联ECG、24小时Holter以及心脏内程序刺激测量QT离散度(QTd)、心率变异性(HRV)、不同部位心肌有效不应期(ERP)、AH和HV间期等心脏电生理指标并评价心律失常发生情况。结果与稳定型人格者相比,不稳定型人格者心脏电生理参数改变为:①ERP及AH间期缩短,ERP-RA:(192.1±27.5)msvs(211.3±28.0)ms,ERP-RV:(196.4±30.9)msvs(220.9±37.8)ms,ERP-CS34:(193.7±27.0)msvs(217.3±30.2)ms;AH:(96.4±15.6)msvs(111.6±15.5)ms,均P<0.01;②QTd增加,(63.2±6.1)msvs(57.9±6.7)ms,P<0.01;③HRV时域分析指标中SDNN、HRV三角指数和RMSSD均明显下降,(115.3±17.8)msvs(137.9±21.6)ms、(42.1±5.5)msvs(48.9±6.2)ms、(24.4±3.6)msvs(30.9±4.9)ms,均P<0.01;SDANN显著增高,(125.4±18.9)msvs(102.3±15.1)ms,P<0.01;④房性、交界性和室性早搏明显增多,(5.9±1.4)个/hvs(4.5±1.1)个/h、(3.9±0.9)个/hvs(3.1±0.7)个/h、(2.3±0.7)个/hvs(1.7±0.5)个/h,均P<0.01。结论人格类型的不同可通过影响自主神经功能状态导致心脏电生理参数的差异,从而产生不同的心律失常易感性。

AIM To investigate the effects of personality types on cardiac electrophysiological parameters and arrhythmias. METHODS According to adult Eysenck personality questionnaire （EPQ）, 97 patients, treated by radiofrequency ablation therapy because of paroxysmal supraventricular tachycardia, were divided into 4 personality types ： introversion and stabilization, introversion and instability, extroversion and stabilization, extroversion and instability. QT dispersion （QTd）, heart rate variability （HRV）, myocardial effective refractory period （ERP） , AH and HV interval and arrhythmias were measured and analyzed by 12 leads ECG, 24 hours Holter and intracardiac programmable stimulation. RESULTS Compared with the patients with stable personality, the patients with unstable personality had shortened ERP and AH interval（P 〈 0. 01 ）, increased QTd （ P 〈 0.01 ） and SDANN （P 〈 0. 01 ）, and decreased SDNN and HRV triangular index and RMSSD（P 〈0. 01）. The atrial, junctonal and ventricular premature beats of the patients with unstable personality also increased （P 〈 0. 01 ）. CONCLUSION Different personality types may accompany different autonomic nervous function, which subsequently results in changed cardiac electrophysiological parameters and various susceptibility to arrhythmias.