扩张型心肌病的心率变异分析

Heart rate variability analysis in patients with dilated cardiomyopathy

目的 :探讨扩张型心肌病患者心脏植物神经功能状况。方法 :分析 31例扩张型心肌病 (DCM)患者和 2 9例正常人 HRV的 Poincare散点图及其定量指标 ,矢量长度指数 (VL I)和矢量角度指数 (VAI) ,并与部分时域指标 (SDNN、SDSD)进行相关分析。结果 :正常人散点图均呈慧星型 ,DCM患者呈鱼雷型及短棒型 ,DCM患者 2 4h、清醒、睡眠时的 VL I、 VA I与 NC组比较均显著降低 ,且昼夜变化节律消失 ,VL I与 SDNN和 VAI与 SDSD分别呈正相关。结论 :扩张型心肌病患者有植物神经损害 ,Poincare散点图能直观地反映扩张型心肌病患者心脏植物神经功能状况 ,结合其量化指标可定量分析扩张型心肌病患者的 HRV。

Objective:To study heart`s autonomic nerve function state in patients with dilated cardiomyopathy (DCM).Methods: Poincare plot and its quantitative index such as vector length index (WLI), vector angle index(VAI)of heart rate varility (HRV) were analysed in 31 patients with DCM and 29 control subjects. The correlations among those indexes and standard deviation (SDNN)and mean successive difference (SDSD) were studied.Results: It showed that poincare plot was comet shape in control subjects, fish torpedo and cosh shape in patients with DCM. WLI, VAI were lower in patients with DOM than in control subjects in 24 hours, sober, dormancy state. The rhythm of day-night change disappeared. There has significant correlation between VLI and SDNN, VAI and SDSD. Conclusion:There may be autonomic nerve injury in patients with DCM, Poincare plot can directly reflect heart autonomic nerve function state. Poincare plot associated with it`s quantitative index may be used to analyse quantitatively HRV in patients with DCM.