儿茶酚胺依赖性多形室速的心率变异性及其β-受体阻滞剂干预后的变化

Heart rate variability of patients with catecholaminergic polymorphic ventricular tachycardia and its changes after β-adrenergic receptor blockers

目的:探讨心率变异在儿茶酚胺依赖性多形室速(catecholaminergic polymorphic ventricular tachycardia,CPVT)危险分层中的应用价值,及其β-受体阻滞剂干预后的变化。方法:根据不同预后对22例(未发猝死组18例,猝死组4例)CPVT患者进行HRV时域指标分析,与正常对照组比较;并比较β-受体阻滞剂干预前、后HRV时域指标的变化。结果:22例CPVT患者HRV各项时域指标均显著低于正常对照组(P<0.001),猝死组显著低于未发猝死组(P<0.001);β-受体阻滞剂可以使其HRV时域指标显著升高(P<0.05)。结论:HRV可以作为CPVT患者发生心脏性猝死的独立预测指标。

Objective: To investigate the heart rate variability (HRV) in patients with catecholaminergic polymorphic ventricular tachycardia (CPVT) and its changes after intervention of adrenergic receptor blockers. Methods: According to the different outcomes, 22 CPVT patients were divided into two groups: group Ⅱ_A (4 cases), in which sudden cardiac death (SCD) happened; group Ⅱ_B (18 cases), in which no SCD happened. Before and after β-adrenergic receptor blocker intervention 6 months, indices of HRV of 22 patients were analyzed. Results: Indices of all patients were much less than those of control group (P<0.001), and HRV of SCD less than that of no-SCD. The indices of HRV significantly increased after intervention of β-adrenergic receptor blockers. Conclusion: HRV can be applied into dangerous grading of patients with CPVT; β-adrenergic receptor blockers can improve the indices of HRV.