窦性心率震荡在冠心病患者中的变化及其预测价值（英文）

Change of heart rate turbulence in coronary artery disease patients and its predictive value

目的:探讨冠心病(CAD)患者窦性心率震荡(HRT)的变化及其预测价值。方法:选择58例冠状动脉造影(CAG)证明的CAD患者为CAD组,另50例CAG阴性的正常人为正常对照组。对所有受检者进行24h动态心电图、冠状动脉造影及心脏彩超检查,比较各组左室射血分数(LVEF)、心率变异性指标等参数的差异。结果:与正常对照组比较,CAD组震荡初始(TO)值明显升高[(-1.34±1.09)%比(2.32±0.60)%],震荡斜率(TS)值明显降低[(11.14±2.27)ms/RR比(3.44±0.60)ms/RR],P均<0.01;在CAD组中随冠状动脉病变严重程度加重(单支、双支、多支病变),TO值显著升高[(1.35±0.52)%比(2.56±0.83)%比(3.01±1.62)%],TS值[(6.49±1.79)ms/RR比(3.33±1.02)ms/RR比(1.66±0.30)ms/RR]显著降低,组间两两比较差异均有统计学意义(P<0.05或<0.01);与无心脏事件CAD组比较,合并心脏事件CAD组TO值[(1.68±0.61)%比(2.24±0.24)%]明显升高、TS[(5.87±1.22)ms/RR比(1.65±0.23)ms/RR]、LVEF[(66.18±2.64)%比(56.36±3.34)%]显著降低(P均<0.01)。结论:CAD患者存在HRT减弱现象,HRT可作为评估CAD患者病情严重程度的指标及预测CAD患者发生再发心脏事件的指标。

Objective：To explore change of heart rate turbulence （HRT）in patients with coronary artery disease （CAD）and its predictive value.Methods：A total of 58 CAD patients were regard as CAD group.The 50 normal persons with negative CAG were regard as normal control group.All subjects received 24h dynamic ECG,CAG and echocardiography examination.Left ventricular ejection fraction （LVEF）and HRT indexes were compared between two groups.Results：Compared with normal control group,there was significant rise in turbulence onset [TO,（-1.34±1.09）% vs.（2.32±0.60）%]and significant reduction in turbulence slope [TS,（11.14±2.27）ms/RR vs. （3.44±0.60）ms/RR]in CAD group,P 〈0.01 both;in CAD group,along with coronary artery lesion aggravated （single-,double-,multi-vessel coronary disease）,there was significant rise in TO [（1.35 ± 0.52）% vs.（2.56 ± 0.83）% vs.（3.01±1.62）%]and significant reduction in TS [（6.49±1.79）ms/RR vs.（3.33±1.02）ms/RR vs. （1.66±0.30）ms/RR],the difference was significant in two-two comparison among all groups,P 〈 0.05 or 〈0.01;compared with CAD without cardiac event group,there was significant rise in TO [（1.68±0.61）% vs.（2.24 ±0.24）%],and significant reduction in TS [（5.87±1.22）ms/RR vs.（1.65±0.23）ms/RR]and LVEF [（66.18 ±2.64）% vs.（56.36±3.34）%]in CAD with cardiac event group,P 〈0.01 all.Conclusion：Weakened HRT phe-nomenon exists in CAD patients.HRT can be treated as an index evaluating severity of CAD patients′condition and an effective predicting index for recurrent cardiac events in CAD patients.