扩张型心肌病患者心率减速力的变化及其临床意义
发布时间：2018-10-24 18:42
【摘要】：目的探讨扩张型心肌病(dilated cardiomyopathy,DCM)患者心率减速力(heart rate deceleration capacity,DC)的变化及其对DCM患者生存率的影响。方法选择在我院住院的69例DCM患者(DCM组)和165例非器质性心脏病患者(对照组),行心脏超声和24小时动态心电图检查,应用相应软件对动态心电图进行分析并记录DC值和心率加速力(heart rate acceleration capacity,AC)值,比较两组间DC值和AC值的差别。对DCM患者进行随访,共随访60个月,观察终点事件为心源性死亡(cardiac death,CD),根据其有无CD分为高风险组(19例)及低风险组(50例),采用Cox回归分析和Kaplan-Meier生存分析DC值对DCM患者生存率的影响。结果1)与对照组相比,DCM患者DC值、AC绝对值均降低(4.0±1.82 vs 7.2±0.53,-4.5±1.91 vs-7.9±1.14,P0.01),DCM患者DC值与左房内径呈负相关(r=-0.278,P0.05);2)与低风险组相比,DCM高风险组患者DC值和AC绝对值明显降低(2.8±1.03vs 4.4±1.94,-3.5±1.16vs-4.9±2.09,P0.05);DCM患者DC值降低是CD的危险因素之一;3)与DC≥4.5ms者相比,DCM组DC值4.5ms者生存率明显降低(log-rank=4.837,P0.05)。结论扩张型心肌病患者心率减速力降低提示自主神经功能受损,是发生心源性死亡的危险因素之一,心率减速力小于4.5ms者生存率下降。
[Abstract]:Objective to investigate the changes of heart rate deceleration force (heart rate deceleration capacity,DC) in patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM) and its effect on survival rate of DCM patients. Methods Sixty-nine patients with DCM (DCM group) and 165 patients with non-organic heart disease (control group) in our hospital were examined by echocardiography and 24 hours ambulatory electrocardiogram. The dynamic electrocardiogram (ECG) was analyzed by using the corresponding software and the DC value and the (heart rate acceleration capacity,AC value of heart rate acceleration were recorded. The difference of DC value and AC value between the two groups was compared. The patients with DCM were followed up for 60 months. Cardiac death (cardiac death,CD) was observed and divided into high risk group (19 cases) and low risk group (50 cases) according to their CD. Cox regression analysis and Kaplan-Meier survival analysis were used to analyze the effect of DC value on the survival rate of DCM patients. Results 1) compared with the control group, the DC value and the absolute AC value of DCM patients were significantly lower (4.0 卤1.82 vs 7.2 卤0.53 卤4.5 卤1.91 vs-7.9 卤1.14 P 0.01, respectively) and the DC values were negatively correlated with the left atrial diameter (r = 0.278 P 0.05), 2) compared with the low risk group, the DC value and AC absolute value of DCM high risk group were significantly lower (2.8 卤1.03vs 4.4 卤1.94 卤3.5 卤1.16vs-4.9 卤2.09 Reduction was one of the risk factors for CD. 3) compared with those with DC 鈮，
本文编号：2292230
[Abstract]:Objective to investigate the changes of heart rate deceleration force (heart rate deceleration capacity,DC) in patients with dilated cardiomyopathy (dilated cardiomyopathy,DCM) and its effect on survival rate of DCM patients. Methods Sixty-nine patients with DCM (DCM group) and 165 patients with non-organic heart disease (control group) in our hospital were examined by echocardiography and 24 hours ambulatory electrocardiogram. The dynamic electrocardiogram (ECG) was analyzed by using the corresponding software and the DC value and the (heart rate acceleration capacity,AC value of heart rate acceleration were recorded. The difference of DC value and AC value between the two groups was compared. The patients with DCM were followed up for 60 months. Cardiac death (cardiac death,CD) was observed and divided into high risk group (19 cases) and low risk group (50 cases) according to their CD. Cox regression analysis and Kaplan-Meier survival analysis were used to analyze the effect of DC value on the survival rate of DCM patients. Results 1) compared with the control group, the DC value and the absolute AC value of DCM patients were significantly lower (4.0 卤1.82 vs 7.2 卤0.53 卤4.5 卤1.91 vs-7.9 卤1.14 P 0.01, respectively) and the DC values were negatively correlated with the left atrial diameter (r = 0.278 P 0.05), 2) compared with the low risk group, the DC value and AC absolute value of DCM high risk group were significantly lower (2.8 卤1.03vs 4.4 卤1.94 卤3.5 卤1.16vs-4.9 卤2.09 Reduction was one of the risk factors for CD. 3) compared with those with DC 鈮，
本文编号：2292230
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