慢性心力衰竭患者心率振荡现象临床观察

Clinical Analysis of Heart Rate Turbulence in Chronic Heart Failure

目的:研究慢性心力衰竭(CHF)患者中,心率振荡现象的变化以及心率振荡与左室射血分数(LVEF)、左室舒张末期内径(LVEDD)的关系。方法:通过NYHA心功能分级法选择心功能Ⅱ级-Ⅳ级的患者102例,另选正常健康对照者80例,采用24h动态心电图记录资料,计算心率振荡现象(HRT)的两个参数,振荡初始(TO)和振荡斜率(TS),同时行心脏彩超比较LVEF与LVEDD两组之间差别;并计算TO、TS、LVEF、LVEDD之间相关性。结果:CHF组TO值显著高于对照组(P<0.01);TS值显著低于对照组(P<0.01)。TO与LVEF、LVEDD之间明显相关。结论:CHF患者室性早搏后的HRT现象减弱,与心功不全程度明显相关。HRT可能作为评价心力衰竭危险分层的新指标。

Objective： To study the change of heart rate turbulence（HRT） in chronic heart failure（CHF）and its relationship with left ventricular ejection fraction （LVEF）and left ventricular end-diastolic diameter （LVEDD）. Methods： 102 patients with CHF and 80 control patients were investigated, HRT onset and slope were measured by the original definitions using Holter monitoring electrocardiogram and its relevance with LVEF and LVEDD were analyzed. The correlation of TO, TS LVEF and LVEDD were measured. Results： The value of the HRT onset was significantly higher in CHF group than that in control group（P〈0.01 ）; the value of the HRT slope in CHF group was significantly lower than that in control group （P〈0.01）. There was a significant correlation between TO and LVEF and LVEDD. Conclusions： HRT was blunted in CHF patients and could be a new predictor of the cardiac high risk.