非缺血性心脏病窦性心律震荡变化及意义

Changes and clinical significance of heart rate turbulence in nonischemic heart disease

目的探讨非缺血性心脏病(NIHD)患者窦性心律震荡(HRT)的变化及意义。方法选择161例NIHD患者及76例正常对照。前者按照随访中有无心血管事件发生分为事件组(101例)和无事件组(60例),均行24 h动态心电图、超声心动图等检查,记录临床资料,计算HRT的震荡初始(TO)和震荡斜率(TS)。结果 NIHD患者TO较对照组升高,TS较对照组降低(P<0.01)。与无事件组比较,事件组TO升高,TS降低(P<0.01)。TO与TS两项均异常是NIHD患者发生主要心血管事件强有力的预测因素。结论 HRT充分反映心脏自主神经功能,是NIHD患者病情评估或危险分层的有用指标。

Objective To study the changes and clinical significance of heart rate turbulence（HRT） in patients with nonischemic heart disease（NIHD）.Methods One hundred and sixty-one patients with NIHD（group A） and seventy-six controls（group C） were enrolled in this study.Group A was subdivided into groups of A1（101 cases with cardiovascular events recorded during follow up） and A2（60 cases without cardiovascular events）.The patients of groups of A and C underwent 24-hour Holter recordings and ultrasonic cardiography to collect HRT parameters of turbulence onset（TO）,turbulence slope（TS） and cardiac function.Results The value of TO was higher,TS was lower,in group A than those in group C（P0.01）.The value of TO was higher,TS was lower,in group A1 than those in group A2（P0.01）.Abnormal TO and TS were the strongest predictive factors for the patients to happen main cardiac events.Conclusion HRT can thoroughly reflect fuctional status of the cardiac autonomic nerve and may be taken as an useful marker for evaluating the severity of NIHD.