缬沙坦治疗对CHF患者心率震荡影响的研究

The therapeutic effects of valsartan on heart rate turbulence in patients with congestive heart failure

目的研究慢性充血性心力衰竭(CHF)病人24h动态心电图(24hDCG)恶性室性心律失常与心率震荡(HRT)的关系,以及缬沙坦干预后HRT的变化。方法选择有室性早搏的病人62例,分为CHF组(27例)和正常对照组(35例),所有病人均行24h动态心电图监测,计算心率震荡的初始值(TO)、震荡斜率(TS);CHF病人在常规治疗基础上加用缬沙坦口服1月后复查24hDCG监测。结果正常对照组TO<0,而CHF组TO>0;CHF组的TS明显低于正常对照组。CHF患者口服缬沙坦1个月前后对比,HRT有明显改善:TO下降,TS升高。结论HRT降低可以做为预测CHF恶性室性心律失常发生的指标;缬沙坦能改善CHF的自主神经功能,从而改善HRT,减少恶性室性心律失常的发生。

Objective To observe the therapeutic effect of valsartan on heart rate turbulence （HRT） in patients with congestic heart failure （CHF）. Methods There 62 patients with premature ventrictdar beats were divided into CHF group consisted of 27 cases and control group consisted of 35 cases . All patients were examined with ambulatory electrocardiogram monitoring for twenty-four hours, and turbulence onset （TO） and turbulence slope （TS） were analyzed. Patients in the CHF group were given orally valsartan and anabulatory electrocardiogram monitoring was examined after a month. Results TO were 〈0 in the control group and〉0 in the CHF group. TS was higher in the control group than that of the CHF group. TO decreased and TS increased respectively after oral administration of valsartan for a month in the CHF group. Conclusion HRT is of clinical prognostic value for predicting sudden death in patients with CHF; Valsartan can improve function of autonomic nerve in CHF patients in addition to improvement of HRT and resuction of malignant ventricular arrhythmia