阿托伐他汀对冠状动脉慢血流患者心率恢复的影响

Effect of Atorvastatin on Heart Rate Recovery in Patients with Slow Coronary Flow Phenomenon

目的:探讨冠状动脉慢血流(coronary slow flow phenomenon,CSFP)患者运动负荷实验后3 min内的心率恢复(heart rate recovery,HRR)改变以及阿托伐他汀对这类患者心率恢复的影响。方法:入选56例CSFP患者,分为常规治疗组(16例)和阿托伐他汀组(40例),另选15例健康体检者为正常对照组。患者治疗前后均进行心电图运动负荷试验,记录静息心率、峰值心率、代谢当量(metabolic equivalent,METs)及运动后3 min内的心率,计算运动后3 min的心率恢复(HRR1,HRR2,HRR3)及心率恢复的校正值(percent recovery of HRR,HRR1%,HRR2%,HRR3%),比较三组间心率恢复指标及METs的关系。结果:(1)治疗前常规治疗组和阿托伐他汀组前2 min的心率恢复值、心率恢复的校正值及METs比较,差异无统计学意义(P>0. 005),但与对照组比较显著减低,差异有统计学意义(P <0. 01)。(2)治疗12周后,阿托伐他汀组前2 min心率恢复值、心率恢复的校正值及METs改善,较治疗前及常规药物治疗后差异有统计学意义(P <0. 01)。结论:冠状动脉血流缓慢患者心率恢复明显减低,给予阿托伐他汀治疗后可以有效改善其心率恢复指标及代谢当量。

Objective To investigate the changes in Heart Rate Recovery （HRR） after maximal exercise treadmill testing in patients with CSFP and the effect of atorvastatin on heart rate recovery. Method 56 patients with CSFP were randomly divided into conventional therapeutic group （n = 16）and atorvastatin therapeutic group（ n = 40）, 15 healthy subjects were chosen as con- trol. Treadmill exercise testing were performed before and after therapy. Heart Rate （HR） was measured at rest, at maximum exer- cise and at 1,2,and 3 minutes into recovery , percent recovery of HRR at 1,2, and 3 minute （HRR1, HRR2, HRR3） were calcu- lated. Results ①There was no significant difference in HRR1, HRR2, HRR1%, HRR2%, and METs Before therapy between two SCFP groups （P 〉 0. 05）, but significantly lower compared with healthy control group. ②Affer 12 weeks therapy, HRR1, HRR2, HRR1% , HRR2%, and METs were significantly impoved in atorvastatin therapeutic group compared before therapy and conven- tional therapeutic group （P 〈 0. 01 ）. Conclusion HRR is markedly attenuated in CSFP patients comared with healthy subjects and therapy with atorvastatin may improve HRR and METs.