| 程美莲,严卫国,胡兴兵.扩张型心肌病患者室性心律失常及心率变异性与左室射血分数的关系[J].中国临床保健杂志,2023,26(2):251-255. |
| 扩张型心肌病患者室性心律失常及心率变异性与左室射血分数的关系 |
| Relationships between ventricular arrhythmia,heart rate variability and left ventricular ejection fraction in patients with dilated cardiomyopathy |
| 投稿时间：2023-01-16 |
| DOI：10.3969/J.issn.1672-6790.2023.02.025 |
| 中文关键词: 心肌病,扩张型 心律失常 每搏输出量 心脏复合征,早搏 心室 |
| 英文关键词: Cardiomyopathy,dilated Arrhythmias Stroke volume Cardiac complexes,premature Heart ventricles 〖FL |
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| 中文摘要: |
| 目的 探讨扩张型心肌病(DCM)患者室性心律失常(VA)及心率变异性(HRV)与左室射血分数(LVEF)的关系,以指导临床治疗。方法 选择2019年1月至2022年9月安徽医科大学附属安庆第一人民医院收治的DCM患者92例作为观察组,选择同期来院的健康体检者50例作为对照组,给予24 h动态心电图(DCG)检查,分析2组VA发生情况及HRV指标。再对观察组行超声心动图(UCG)检查,根据LVEF水平分为LVEF≥40%(A组)、LVEF 30%~39%(B组)、LVEF<30%(C组),比较各组VA发生情况及HRV指标,并探讨其与LVEF的关系。结果 观察组VA发生率较对照组显著增高,HRV指标较对照组显著降低,差异有统计学意义(P<0.01)。观察组以复杂性室早、室性心动过速发生为主,对照组以单纯性室早发生为主,差异有统计学意义(P<0.01)。观察组不同LVEF分级患者单纯性室早、复杂性室早和室速发生情况总体差异无统计学意义(P>0.05)。观察组随着LVEF减低,HRV指标逐渐降低,差异有统计学意义(P<0.05)。相关性分析结果显示:VA严重程度与LVEF无相关性(rs=-0.084,P>0.05),HRV指标与LVEF正相关,其中以RR间期总体标准差相关性最强(r=0.398,P<0.01)。结论 DCM患者VA发生率显著增高,多表现为复杂性室早和(或)室性心动过速,HRV指标显著降低。其LVEF值与HRV指标具有良好相关性,但与VA无明显相关。 |
| 英文摘要: |
| Objective To explore the relationships between ventricular arrhythmia,heart rate variablilty and left ventricular ejection fraction in patients with dilated cardiomyopathy,so as to guide clinical treatment.Methods Ninty two patients with DCM who were hospitalized in Anqing First People′s Hospital Affiliated to Anhui Medical University from January 2019 to September 2022 were selected as the observation group,50 healthy people who came to our hospital for physical examination in the same period were selected as the control group.Dynamic electrocardiogram monitoring was performed in each group,the occurrence of VA and HRV indexes in the two groups were analyzed.Then the observation group was divided into three groups according to the level of left ventricular ejection fraction in echocardiography [LVEF≥40%(group A);LVEF 30%-39%(group B);LVEF<30% (group C)].The occurrence of VA and HRV indexes in each group were compared to explore the relationships between left ventricular dysfunction and VA and HRV in patients with DCM.Results The incidence of VA in the observation group was significantly higher than that in the control group,and the HRV index was significantly lower than that in the control group.The difference was statistically significant (P<0.01).Complex ventricular premature beats and ventricular tachycardia occurred mainly in the observation group,while simple ventricular premature beats occurred mainly in the control group.the difference was statistically significant (P<0.01).There was no significant difference in the incidence of simple premature ventricular beats,complex premature ventricular beats and ventricular tachycardia among patients with different LVEF grades in the observation group (P>0.05).With the decrease of LVEF,HRV index gradually decreased,and the difference was statistically significant (P<0.05).The results of correlation analysis showed that there was no correlation between VA severity and LVEF(rs=-0.084,P>0.05),but HRV index was positively correlated with LVEF,among which SDNN had the strongest correlation (r=0.398,P<0.01).Conclusion The incidence of VA in patients with DCM is significantly increased,most of which show complex premature ventricular beats or (and) ventricular tachycardia,and the HRV index is significantly decreased.The LVEF value has a good correlation with HRV index,but it is not closely related to VA. |
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