窦性心率震荡预测心肌梗死后心衰  

Predictive Values of Heart Rate Turbulence Parameters on Heart Failure in Patients with Old Myocardial Infarction

作　　者：孜亚吾东.巴吾东 周贤慧[2] 汤宝鹏 

机构地区：[1]伊犁州友谊医院,835000 [2]新疆医科大学第一附属医院,830000

出　　处：《临床心电学杂志》2014年第6期435-438,共4页Journal of Clinical Electrocardiology

摘　　要：目的本研究目的在于探讨性窦心率震荡(HRT)预测陈旧性心肌梗死(OMI)后发生心力衰竭的价值。方法对192例有完整资料的OMI患者进行回顾性分析,将其分为:A组(合并心力衰竭)和B组(无心力衰竭),选择年龄、性别相匹配的无心肌梗死病史的90例患者作对照组。根据动态心电图结果分析HRT指标震荡初始(TO)、震荡斜率(TS)和静息心率(RHR)、正常心动周期标准差(SDNN)。利用超声心动图对OMI患者进行心功能评价,测量左室射血分数(LVEF)和左室舒张末期内径(LVEDD)。分析HRT指标和SDNN、RHR、LVEF、LVEDD的相关性。结果 1A组TO和TS与B组及对照组比较,均有统计学差异(p<0.05),B组TO和TS均在正常范围内,但与正常对照组比较仍有统计学差异;2A组LVEF、LVEDD、SDNN、RHR均与B组及对照组具有显著的统计学差异(p<0.05);3相关性分析显示TO与SDNN呈负相关,但TO和其他因素无明显相关性,TS与SDNN和LVEF呈正相关,而与LVEDD和RHR呈负相关。结论 HRT尤其是量化的TS能更好地预测OMI患者合并心力衰竭的风险,对于降低梗死后心力衰竭的发生率、改善预后和降低死亡率具有重要的临床应用价值。Objective To explore the predictive values of heart rate turbulence parameters（HRT） on heart failure in patients with old myocardial infarction patients. Methods Left ventricular function such as left ventricular end-diastolic dimension（LVEDD） and left ventricular ejection fraction（LVEF） was assessed by echocardiography.We obtained a 24 h Holter ECG recording to assess the HRT parameters, includedturbulence onset（TO）, turbulence slope（TS）, standard deviation of NN intervals（SDNN）, and resting heart rate（RHR）. The relationships between HRT parameters and SDNN, RHR, LVEF, LVEDD were determined. Results ①There were significant differences in TO and TS between group A and group B, control group（p〈0.05）. However, there was no significant difference in TO and TS between group B and control group; ②There were significant differences in LVEF, LVEDD, SDNN and RHR between group A and group B, control group（p〈0.05）; ③Correlation analyses indicated that TO negatively correlated with SDNN, but no associations were found between TO and other factors. TS positively correlated with SDNN and LVEF. However, TS negatively correlated with LVEDD and RHR. Conclusions HRT, especially TS is a powerful prognostic factor and should be investigated in OMI patients with CHF.

关 键 词：窦性心率震荡 陈旧性心肌梗死 心力衰竭 震荡初始 震荡斜率 

分 类 号：R542.22[医药卫生—心血管疾病]