心力衰竭合并室性心律失常患者心率变异性与心功能的相关性

Correlation between heart rate variability and cardiac function in patients with heart failure complicated by ventricular arrhythmia

目的分析心力衰竭合并室性心律失常患者心率变异性(HRV)与心功能的相关性。方法回顾性抽取2021年1月至2023年6月南阳市第二人民医院收治的76例心力衰竭合并室性心律失常患者作为观察组,按照1∶1比例抽取76例单纯心力衰竭患者作为单纯组。所有患者检测HRV时域指标[24 h内每5 min的R-R间期标准差(SDNN)、R-R间期平均差(SDANN)、邻近R-R间期均方差(rMSSD)、相邻心动周期≥50 ms的R-R间期差值百分比(PNN50)]和心功能指标[左心心射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心房内径(LA)],比较两组上述指标水平,应用Pearson检验分析HRV与心功能的相关性。结果观察组24 h内每5 min的SDNN、SDANN、rMSSD、PNN50低于单纯组(P<0.05)。观察组LVEF低于单纯组(P<0.05),LVEDD、LA高于单纯组(P<0.05)。Pearson结果显示,SDNN、SDANN、rMSSD、PNN50与LVEF呈正相关(r=0.47、0.52、0.50、0.60,P均<0.05),与LVEDD、LA呈负相关(r=-0.45、-0.46,-0.42、-0.52,-0.56、-0.49,-0.58、-0.62;P均<0.05)。结论心力衰竭合并室性心律失常患者HRV与心功能相关,HRV时域指标较低时LVEDD、LA较高而LVEF较低。

Objective To analyze the correlation between heart rate variability(HRV)and cardiac function in patients with heart failure(HF)complicated by ventricular arrhythmia.Methods A total of 76 patients with HF complicated by ventricular arrhythmia treated in Nanyang Second General Hospital from January 2021 to June 2023 were retrospectively selected as the observation group;meanwhile,76 patients with only HF were selected as the simple group in a ratio of 1∶1.HRV time-domain indexes,including standard deviation of normal-to-normal intervals(SDNN),standard deviation of the averages of normal-to-normal intervals(SDANN),root mean square of successive differences in adjacent normal-to-normal intervals(rMSSD),percentage of intervals>50 ms different from preceding interval(PNN50)in all 5-minute segments of the 24-hour recording,and cardiac function indexes,including left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)and left atrium diameter(LA),were detected in all patients.Levels of the above indexes were compared between the two groups.And the correlation between HRV and cardiac function was analyzed by Pearson test.Results The levels of SDNN,SDANN,rMSSD and PNN50 in all 5-minute segments of the 24-hour recording in the observation group were lower than those in the simple group(P<0.05).Compared with the simple group,the observation group had lower LVEF,higher LVEDD and higher LA(P<0.05).The results of Pearson test showed that SDNN,SDANN,rMSSD and PNN50 were positively correlated with LVEF(r=0.47,0.52,0.50,0.60;all P<0.05),and were negatively correlated with LVEDD and LA(r=-0.45,-0.46,-0.42,-0.52,-0.56,-0.49,-0.58,-0.62;all P<0.05).Conclusions HRV is associated with cardiac function in patients with heart failure complicated by ventricular arrhythmias.In patients with lower HRV time-domain indexes,LVEDD and LA are higher,but LVEF is lower.