脑钠钛、左室舒张末内径与心率震荡的关系

Correlation of B-type natriuretic peptide,left ventricular end diastolic diameter with heart rate turbulence

目的探讨脑钠肽、左室舒张末内径与心率震荡(heart rate turbulence,HRT)之间的关系,评价心率震荡现象在心功能不全中的意义。方法选择左室舒张末内径增大及脑钠肽增高患者69例(心衰组)和非器质性心脏病患者58例(对照组)。根据24 h动态心电图(Holter)记录资料,计算震荡初始(turbulence onset,TO)和震荡斜率(turbulence slope,TS),比较两组之间的差异,并分析TO、TS与脑钠肽、左室舒张末内径之间的相关性。结果心衰组TO值显著高于对照组(P<0.01);心衰组TS值显著低于对照组(P<0.01)。心衰组中TO与左室舒张末内径之间明显正相关,TS与脑钠肽、左室舒张末内径明显负相关。结论心衰患者室性早搏后的HRT现象减弱能成为评价心功能不全患者自主神经功能状态的一个指标,并可作为心衰危险及严重程度的预测指标。

Objective To explore the relationship of brain natriuretic peptide（proBNP）,left ventricular end diastolic diameter（LVEDd） with heart rate turbulence（HRT）and to evaluate the significance of heart rate turbulence in cardiac insufficiency.Methods A total of 69 patients with increased left ventricular end diastolic diameter and brain natriuretic peptide were chosen as heart failure group,and 58 patients with non-organic heart diseases were chosen as control group.According to 24 h Holter recording data,turbulence onset（TO） and turbulence slope（TS） were calculated and compared between heart failure group and control group.The correlation of TO and TS with proBNP,LVEDd was analyzed.Results TO was significantly higher in heart failure group than in control group（P0.01）,while TS was significantly lower in heart failure group than in control group（P0.01）.TO was positively related to LVEDd,and TS was negatively related to proBNP and LVEDd in heart failure patients（P0.01）.Conclusion The phenomenon of diminished HRT after premature ventricular contractions may be a new indicator for evaluating the autonomic nervous function in patients with cardiac insufficiency,and can be used to a predictor of risk and level of heart failure.