扩心病患者心率减速力与BNP前体的相关性分析

Depressed deceleration capacity of heart rate are correlated with high levels of N-terminal Pro-B-type natriuretic peptide in dilated cardiomyopathy

目的分析扩张型心肌病(DCM)患者心率减速力(DC)以及心率变异性(HRV)与氨基末端脑钠肽前体(NT-pro BNP)的关系并探讨其临床意义。方法选取30名DCM患者(DCM组)及34名健康人(对照组),记录其24h动态心电图资料,计算机自动分析DC,HRV时域指标(SDNN和r MSSD),静脉采血检测血浆中NT-pro BNP含量,超声心动图测定其左室射血分数(LVEF)。结果 DCM组与对照组的DC、SDNN和r MSSD相比差异具有统计学意义;DCM组的DC与NT-pro BNP呈明显负相关,HRV与NT-pro BNP则无明显相关性。结论 DC是较HRV能更好地反映DCM患者自主神经功能并判断其预后的指标。

Objective Dilated cardiomyopathy （DCM） patients are the potential population of sudden cardiac death. In the current study, we investigated the relationships between deceleration capacity of heart rate （DC） or heart rate variability （HRV） and plasma levels of N-terminal Pro-B-type natriuretic peptide （Nt-proBNP） in DCM patients. Methods We enrolled 30 DCM patients （〈70 years） and 34 age- and sex-matched participants with normal results of physical examination in sinus rhythm. Phase-rectified signal averaging -derived DC, HRV, including standard deviation of normal R-R intervals （SDNN）, squares of differences between adjacent NN intervals （rMSSD）, were accessed by 24h electrocardiographic Holter monitoring. Plasma level of NT-proBNP was measured from blood samples taken on admission. Left ventricular eject fraction （LVEF） was assessed by biplane echocardiography. Results There were significant differences of DC, SDNN and rMSSD between the DCM group and the control group. DC was negatively correlated with the levels of NT-proBNP in DCM patients. SDNN and rMSSD, have no correlation with the levels of NT-proBNP in DCM group. Conclusions DC is probably a better predictor of risk stratification and regulation of autonomic nervous system than HRV in DCM patients.