CAJ | 학술논문

目的探讨心力衰竭患者心率震荡(HRT)的变化及其与心力衰竭严重程度的相关性.方法对心力衰竭患者(83例)及对照组患者(36例)进行24 h动态心电图检查,分别计算震荡初始(TO)和震荡斜率(TS),比较2组患者TO及TS均值;并比较不同心力衰竭严重程度及心功能分级下的HRT.结果心力衰竭组的TO值高于对照组[(-0.31±-0.17)%与(-1.63±-0.23)%,P＜0.01)],TS值低于对照组[(2.24±1.42)ms/R-R与(8.73±3.68)ms/R-R,P＜0.001)];在心力衰竭组,存在肢端水肿、颈静脉怒张、肺淤血、心胸比增大、左心室射血分数降低、心腔扩大、心率增快和心率变异异常的患者,其TO值明显升高,TS值明显降低(P均＜0.05);按照纽约心脏病学会心功能分级标准,分级水平越高,TO值越高、而TS值越低.结论慢性心力衰竭患者心率震荡现象明显受损;心率震荡的减弱与心力衰竭严重程度密切相关.
목적 탐토심력쇠갈환자심솔진탕(HRT)적변화급기여심력쇠갈엄중정도적상관성.방법 대심력쇠갈환자(83례)급대조조환자(36례)진행24 h동태심전도검사,분별계산진탕초시(TO)화진탕사솔(TS),비교2조환자TO급TS균치;병비교불동심력쇠갈엄중정도급심공능분급하적HRT.결과 심력쇠갈조적TO치고우대조조[(-0.31±-0.17)%여(-1.63±-0.23)%,P＜0.01)],TS치저우대조조[(2.24±1.42)ms/R-R여(8.73±3.68)ms/R-R,P＜0.001)];재심력쇠갈조,존재지단수종、경정맥노장、폐어혈、심흉비증대、좌심실사혈분수강저、심강확대、심솔증쾌화심솔변이이상적환자,기TO치명현승고,TS치명현강저(P균＜0.05);안조뉴약심장병학회심공능분급표준,분급수평월고,TO치월고、이TS치월저.결론 만성심력쇠갈환자심솔진탕현상명현수손;심솔진탕적감약여심력쇠갈엄중정도밀절상관.
Objective To study the changes of heart rate turbulence(HRT)in patients with chronic heart failure.Methods 24 h Hoher ECG recordings were examined in 83 patients with heart failure(HF)and 36 in the comparison group.Turbulence onset(TO)and turbulence slope(TS)were calculated from Hoher recordings.The mean value of TO,TS between the two groups were compared;TO and TS in defferent degree of severity of HF,HRT of different New York Heart Association Classification(NYHA)were also compared.Results TO is significantly higher in the HF group than in the comparison group[(-0.31±-0.17)%vs(-1.63 ±-0.23)%,P＜0.01)],and TS in the HF group is significantly lower[(2.24±1.42)ms/R-R vs(8.73±3.68)ms/R-R,P＜0.01)].In the HF group,TO is higher and TS is lower in patients with the third tone,peripheral edenlas,jugular distension,pulmonary congestion,cardiothoracic ratio＞0.55,LVEF＜45%,LVESD＞46 mm,LVEDD＞60 mm,HR＞80 bpm and HRV＜70 ms(P＜0.05).The difference of HRT for patients in different NYHA classification is significant.Conclusion The existence of heart rate turbulence is significantly impaired in patients with chronic heart failure,which reflects the severity of HF well.