扩张型心肌病患者的DC、AC、HRV检测及其与心功能的相关性

Detection of heart rate deceleration capacity,heart rate acceleration capacity,and heart rate variability in patients with dilated cardiomyopathy and its correlation with cardiac function

目的检测扩张型心肌病患者的心率减速力(DC)、心率加速力(AC)、心率变异性(HRV),并探讨其与心功能的相关性。方法回顾性分析2018年3月至2020年3月延安大学咸阳医院收治的120例扩张型心肌病患者的病历资料(观察组),并选择同期于我院接受健康体检的老年人群100例作为对照组。比较两组受检者的DC、AC、连续平均正常RR间期标准差(SDNN)、相邻RR间期差值的均方根(rMSSD)、相邻RR间期平均值的标准差(PNN_(50))、左室舒张末期内径(LVEDD)、左房舒张末期前后径(LAED)和左室射血分数(LVEF),并采用Pearson相关分析法对DC、AC、HRV与LVEDD、LAED与LVEF的相关性进行分析。结果观察组患者的DC、AC分别为(6.70±1.08)ms、(7.38±1.42)ms,明显高于对照组的(4.28±1.25)ms、(5.01±1.14)ms,差异均有统计学意义(P<0.05);观察组患者的SDNN、rMSSD、PNN_(50)分别为(88.12±12.04)ms、(36.57±7.10)ms、(10.22±3.08)%,明显低于对照组的(141.20±20.38)ms、(51.30±12.51)ms、(24.51±5.60)%,差异均有统计学意义(P<0.05);观察组患者的LVEDD、LAED分别为(71.48±8.80)mm、(40.10±7.19)mm,明显高于对照组的(38.69±5.37)mm、(22.01±4.50)mm,LVEF水平为(24.20±3.48)%,明显低于对照组的(70.00±8.66)%,差异均具有统计学意义(P<0.05);经Pearson相关分析结果显示,DC、AC与LVEDD、LAED均呈正相关(r=0.718、0.604、0.550、0.720,P<0.05),与LVEF均呈负相关(r=-0.501、-0.496,P<0.05),SDNN、rMSSD、PNN_(50)与LVEDD、LAED均呈负相关(r=-0.627、-0.574、-0.381、-0.456、-0.410、-0.792,P<0.05),与LVEF均呈正相关(r=0.772、0.585、0.919,P<0.05)。结论扩张型心肌病患者DC、AC、HRV与心功能密切相关,对其检测有助于病情的评估和指导临床治疗。

Objective To detect the heart rate deceleration capacity(DC),heart rate acceleration capacity(AC),and heart rate variability(HRV)in patients with dilated cardiomyopathy,and to explore their correlation with cardiac function.Methods The medical records of 120 patients with dilated cardiomyopathy admitted to the Department of Cardiology in Xianyang Hospital of Yan'an University from March 2018 to March 2020 were retrospectively analyzed as the observation group,and 100 elderly patients who underwent physical examination in the hospital during the same period were selected as the control group.The DC,AC,standard deviation of continuous mean normal RR intervals(SDNN),the root mean square of the difference between adjacent RR intervals(rMSSD),and the standard deviation of the mean value of adjacent RR intervals(PNN_(50)),left ventricular end-diastolic diameter(LVEDD),left atrial end-diastolic diameter(LAED),and left ventricular ejection fraction(LVEF)were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between DC,AC,HRV and LVEDD,LAED and LVEF.Results The DC and AC levels of patients in the observation group were(6.70±1.08)ms and(7.38±1.42)ms,which were significantly higher than(4.28±1.25)ms and(5.01±1.14)ms of the control group(P<0.05).The levels of SDNN,rMSSD,and PNN_(50) in the observation group were(88.12±12.04)ms,(36.57±7.10)ms,and(10.22±3.08)%,which were significantly lower than(141.20±20.38)ms,(51.30±12.51)ms,(24.51±5.60)%in the control group(P<0.05).The LVEDD and LAED levels of the observation group were(71.48±8.80)mm and(40.10±7.19)mm,which were significantly higher than(38.69±5.37)mm and(22.01±4.50)mm of the control group;the LVEF level was(24.20±3.48)%,which was significantly lower than(70.00±8.66)%of the control group;the difference were statistically significant(P<0.05).Pearson correlation analysis showed that DC and AC levels were positively correlated with LVEDD and LAED levels(r=0.718,0.604,0.550,0.720,P<0.05),and negatively correlated with LVEF levels(r=-0.501,-0.496,P<0.05).SDNN,rMSSD,PNN50 levels were negatively correlated with LVEDD and LAED levels(r=-0.627,-0.574,-0.381,-0.456,-0.410,-0.792,P<0.05),and were positively correlated with LVEF levels(r=0.772,0.585,0.919,P<0.05).Conclusion DC,AC,and HRV in patients with dilated cardiomyopathy are closely related to cardiac function,and their detection is helpful to evaluate the condition and guide clinical treatment.