心率对急性心肌梗死收缩性心力衰竭发生率的影响

Impact of heart rate on systolic heart failure incidence inpatients with acute myocardial infarction

目的:采用荟萃分析的方法确定我国人群心率对急性心肌梗死(AMI)患者收缩性心力衰竭(心衰)发生率的影响。方法:全面收集国内发表的有关AMI患者静息心率与左室收缩功能关系的文献,对符合条件的所有研究结果利用RevMan软件,进行固定效应模型和随机效应模型分析。计算AMI患者心率慢组相对心率快组收缩性心衰发生危险的优势比(OR),评价心率快慢对AMI患者心衰发生的影响。结果:符合纳入标准的共5篇文献,总样本量822例。其中心率慢组408例,发生心衰103例;心率快组414例,发生心衰187例;合并OR=0.46,95%CI0.34～0.64。结论:AMI患者心率水平与收缩性心衰之间存在关联。AMI后心率增快者左室收缩功能受损,心率可能作为评估AMI病情的预测指标之一。

Objective：By meta analysis,we determined the influence of heart rate on systolic heart failure incidence in Chinese population with acute myocardial infarction（AMI）. Method：A comprehensive collection of an epidemiological study published domestically on the relationship between resting heart rate and left ventricular systolic function in AMI patients,was carried out,for making the meta analysis by using RevMan software with fixed effects model and random effects model.We calculated the odds ratio（OR） of systolic heart failure risk of AMI patients in slow heart rate group relative to quick heart rate group,evaluated the influence of heart rate level with AMI on occurrence of heart failure,and analyzed the publication bias by funnel plot. Result：The 5 articles were included.The total sample size was 822 cases.There were 408 cases in the heart rate slow group,heart failure appeared in 103 cases.The heart rate quick group was 414 cases,187 cases combined with heart failure;OR=0.46,95% CI was（0.34-0.64）.Funnel plot analysis showed no presence of publication bias. Conclusion：There is a correlation between heart rate level and systolic heart failure occurrence in AMI patients.Left ventricular systolic function is impaired in heart rate quick patients.Heart rate maybe is forecasting marker to assess severity of AMI.