慢性心力衰竭患者心率震荡的检测及其临床意义

Detection and Clinical Significance of Heart Rate Turbulence in Patients with Chronic Heart Failure

目的观察慢性心力衰竭患者窦性心率震荡(HRT)的变化,探讨其临床意义。方法选择慢性心力衰竭伴室性期前收缩(PVS)患者(观察组)51例。另选择年龄、性别相匹配的有PVS而无器质性心脏病者(对照组)50例。所有受试者均进行心脏超声、B型脑钠肽(BNP)及24h动态心电图(DCG)检测,计算HRT指标:震荡起始(TO)、震荡斜率(TS)值。采用SPSS13.0统计软件进行分析。P<0.05为差异有统计学意义。结果观察组TO为(0.89±2.12)%,TS为(3.01±1.21)mm/RR,左室射血分数(LVEF)为(35.40±7.49)%,左室舒张末径(LVEDD)为(60.30±7.01)mm,BNP与对照组比较,有显著性差异,P<0.001。结论慢性心力衰竭患者HRT现象明显减弱或消失,此值可能成为评价慢性心力衰竭患者自主神经功能状态的新指标。

Objective To observe the changes and significance of heart rate turbulence in patients With chronic heart failure（CHF） .Methods 51 patients with chronic heart failure and premature ventricular systole（PVS） were in the testing group.50 cases without organic heart disease,who were matched with the testing group in the age and sexuality,were chosed as the control group.All patients received examination of echocardiogram,BNP and 24h digitized Holter recordings.The value of turbulence onset（TO） and turbulence slope（TS） of HRT were calculated individually.All data were analyzed by software spss13.00.P0.05 was considered as significant.Results In the testing group the value of To,TS,LVEF and LVEDD were individually 0.89±2.21%,3.01±1.12mm/RR,60.3±7.01%mm,which has significant difference compared with the control group（P0.01） .Conclusion HRT was significantly blunted or disappeared in CHF patients,which can be a new marker to evaluate cardiac autonomic nerve status of patients with CHF.