扩张型心肌病患者窦性心率震荡分析  

Heart rate turbulence analysis in dilated cardiomyopathy patients

作　　者：朱少辉[1] 孙芸芸[1] 戴海蓉[2] 

机构地区：[1]广东省人民医院,510080 [2]中山大学第一附属医院,510080

出　　处：《临床心电学杂志》2009年第2期111-114,共4页Journal of Clinical Electrocardiology

摘　　要：目的分析扩张型心肌病(DCM)患者心率震荡(HRT)的特点。方法从2000年10月～2007年11月就诊的DCM患者中选取符合HRT分析条件的31例患者(DCM组),同时选取同期30例健康者作为对照组,比较两组的震荡初始(TO)和震荡斜率(TS),并分析TO、TS与心率变异性指标、左室射血分数(LVEF)及左室舒张末期内径(LVEDD)等之间的相关性。结果DCM组中,TO>0且TS<2.5者8例(25.8%),TO>0且TS>2.5者8例(25.8%),TO<0且TS<2.5者7例(22.6%),TO<0且TS>2.5者8例(25.8%)。两组TO值分别为-0.06±0.03、0.04±0.02,TS值分别为37.2±17.6ms/RRI、11.8±9.7ms/RRI,两组间比较TO、TS值均有统计学差异(p<0.01)。两组正常窦性RR间期的标准差(SDNN)、SDANN、LVEF、LVEDD等指标均有统计学差异(p<0.01)。DCM组TO值与LVEF、SDNN、SDANN之间呈明显负相关,与LVEDD呈明显正相关;TS值与LVEF、SDNN、SDANN之间呈明显正相关,与LVEDD呈明显负相关。结论DCM患者室性早搏后的HRT现象减弱或消失,HRT指标与SDNN、SDANN、LVEF、LVEDD等指标有较好的相关性,可作为DCM患者预后指标之一。Objective To summarize and analyze the characteristics of heart rate turbulence （HRT） in diahed cardiomyopathy （DCM） patients. Methods Thirty-one visiting DCM patients in our hosptial from October 2000 to November 2007 who matched HRT analysis conditions were enrolled as DCM group, and 30 healthy people were enrolled as the control group. HRT parameters including turbulence onset （TO） and turbulence slope （TS） in these two groups were compared. The correlation between HRT parameters and respectively heart rate variability （HRV） parameters, left ventricule ejection fraction （LVEF） or left ventrieular end-diastolic dimension （LVEDD） was also analyzed. Results In DCM group, 25.8 percent （8/31） patients were TO〉0 and TS〈2.5, 25.8 percent （8/ 31） were TO〉0 and TS〉2.5, 22.6 percent （7/31） were TO〈0 and TS〈2.5, and 25.8 percent （8/31） patients were TO〈0 and TS〉2.5. In DCM and the control group, TO were respectively -0.06 ± 0.03 and 0.04 ± 0.02; TS were respectively 37.2 ± 17.6 ms/RRI and 11.8 ± 9.7 ms/RRI. TO and TS were significantly different between these two groups （p〈0.01）. The other parameters such as standard deviation of normal-to-normal intervals （SDNN）, SDANN, INEF and LVEDD were significantly different between these two groups （p〈0.01）. In DCM group, TO was negtively correlated with LVEF, SDNN and SDANN, and was positively correlated with LVEDD; TS was positively correlated with LVEF, SDNN and SDANN, and was negtively correlated with LVEDD. Conclusions Heart rate turbulence phenomenon diminishes or disappeares in diahed eardiomyopathy patients. HRT parameters could be considered as prognosis indicatros of DCM, since their strong correlativity with classcial and typical prognostic parameters such as SDNN, SDANN, LVEF and LVEDD.

关 键 词：扩张型心肌病 心率震荡 震荡初始 震荡斜率 室性早搏 

分 类 号：R542.2[医药卫生—心血管疾病]