心率变异性减低与老年人心血管事件  

Relationship between reduced heart rate variability and cardiac events in the elderly

作　　者：刘德平[1] 吴军[1] 董榕[1] 巨小曚 杨春英[1] 郭正红[1] 乔巍巍[1] 窦岩[1] 

机构地区：[1]北京医院心内科,100730

出　　处：《中华心律失常学杂志》2000年第3期188-190,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　评价老年人群心率变异性 (heartrate variability,HRV)减低与心血管事件的关系。方法　回顾性分析我院干部查体 2 4h动态心电图 HRV资料与心血管事件的关系。共 390例。HRV分析包括时域分析和频域分析。时域分析包括正常 RR间期的标准差 (SDNN) ;5 m in平均 RR间期的标准差 (SDANN) ;相邻 RR间期之差的均方根值 (r MSSD) ;爱丁堡指数 (PNN5 0 ) ,频域分析用快速傅立叶转换方法获得心率功率谱密度。并分析总频谱 (TF,0 .0 1～ 0 .5 0 Hz) ,低频 (L F,0 .0 4～ 0 .15 Hz)成分 ,高频(HF,0 .15～ 0 .40 Hz)成分和低频与高频比率 (L F/ HF)。心血管事件包括急性心肌梗死 ,心力衰竭 ,持续性室性心动过速 ,心室颤动 ,心脏性死亡 (包括心脏性猝死 )。比较查体者有和无心血管事件组之 SDNN,SDANN,RMSSD,PNN5 0 ,L F,HF,TF和低频与高频比率 (L F/ HF)有无差别。　结果　有 2 9例老年人发生心血管事件 (n=2 9) ,有心血管事件组之 SDNN为 (91.7± 30 .3) ms,SDANN(84.6± 2 7.9) ms,r MSSD(2 0 .8± 8.8) ms,PNN5 0 (3.8± 5 .0 ) % ,L F(85 .5± 6 9.3) m s2 ,HF(5 2 .1± 35 .5 ) ms2 ,TF(333.3± 2 2 1.2 ) m s2 ,L F/ HF1.6± 1.0。无心血管事件组 (n=36 1)之 SDNN为 (115 .8± 39.2 ) m s,SDANN(10 3.Objective To evaluate the relationship between reduced heart rate variability(HRV) and cardiac events in general elderly population. Methods We retrospectively analyzed the 24 hour dynamic electrocardiography in 390 elderly patients who underwent this study during their routine annual physical checkup.HRV data including time domain analysis and frequency domain analysis were analyzed.Time domain analysis included the standard deviation of normal RR intervals(SDNN),the standard deviation of 5 min average normal RR intervals(SDANN),the square root of the mean of the squared differences between adjacent normal RR intervals (rMSSD) and percentage of differences between adjacent normal RR intervals exceeding 50 milliseconds (PNN50).Frequency domain analysis included low frequency (LF,0 04～0 15 Hz),high frequency(HF,0 15～0 40 Hz),total frequency(TF,0 01～0 50 Hz) and LH/HF ratio. Results Twenty nine cases developed cardiac events including acute myocardial infarction ( n =12),heart Failure( n =13),sustained ventricular tachycardia and ventricular fibrillation ( n =1) and cardiac death( n =17,5 with sudden cardiac death).SDNN,SDANN,rMSSD,PNN50,LF,HF,TF and LF/HF ratio were (91 7±30 3) ms,(84 6±27 9) ms,(20 8±8 8) ms,3 8±5 0%,(85 5±69 3) ms 2,(52 1±35 5) ms 2,(333 3±221 2) ms 2,1 6±1 0 respectively in cardiac event group( n =29).(115 8±39 2) ms,(103 0±34 5) ms,(30 3±22 9) ms,9 0±14 4%,(439 8±1222 7) ms 2,(236 8±633 2) ms 2,(1109 2±2425 8) ms 2,2 2±1 2 in non cardiac event group( n =361) respectively.There are significant differences in HRV parameters between two groups ( P <0 05～ P =0 0001). Conclusion Elderly population with reduced HRV have strong association with increased cardiac events.

关 键 词：动态心电图 心率变异性 老年人 心脏性死亡 

分 类 号：R592[医药卫生—老年医学]