慢性心衰患者心率减速力与室性心律失常的相关性研究

Study on the relationship between deceleration capacity of rate and ventricular arrhythmia in patients with chronic heart failuer

目的:探讨慢性心力衰竭(CHF)患者心率减速力(DC)与室性心律失常(VA)的相关性。方法:选择146例CHF患者为研究对象,同期选择108例体检健康人群为对照组。所有入选者均行24 h动态心电图和超声心动图检查,离线计算DC值、心率变异性(HRV)时域指标,比较两组数据,分析CHF患者的DC值、HRV时域值与VA之间的关系。结果:CHF组DC值和HRV时域值均比对照组显著降低(P<0.01);CHF组的DC值、正常R-R间期标准差(SDNN)、每5 min R-R间期平均值标准差(SDANN)及相邻R-R间期差值大于50 ms的百分数(p NN50)均与VA程度呈负相关(P<0.05)。结论:CHF患者DC值和HRV时域指标越低,越易发生恶性VA。早期对CHF患者进行干预性治疗有利于降低恶性VA发生率及患者死亡率。

Objective： To investigate the relationship between deceleration capacity of rate（ DC） and ventricular arrhythmia（ VA） in patients with chronic heart failure（ CHF）. Methods： One hundred and forty-six patients with chronic heart failure were selected as objects of the study and 108 medical examination healthy people were chosen as control group. All inductees underwent 24 h ambulatory electrocardiogram and ultrasonic echocardiography,the DC and time-domain HRV indexes was measured by the original definitons using digitized. Two groups statistics were compared,the correlation of DC,HRV with VA in patients with chronic heart failure was analyzed. Results：The DC value and HRV time-domain indexes in CHF group were significantly lower than those in control group（ P〈0. 01） and there was negative correlation in CHF group between DC,the normal R-R interval standard deviation（ SDNN）,the average standard deviation of each 5 min R-R interval（ SDANN）,the percentage of R-R interval difference of greater than 50 ms（ p NN50） and VA level（ P〈0. 05）. Conclusion： The lower the DC value and HRV time-domain indexes of CHF patients are,the more likely the serious VA is to occur. Early intervention on chronic heart failure may help to reduce the occurrence of malignant VA and mortality.