冠心病严重度与心率变异的关系

目的:探讨冠心病严重度对心率变异性的影响及其关系。方法:选择130例完成冠状动脉造影(CAG)的病例,对冠状动脉病变进行Gensini评分,并分为对照组(39例)、冠状动脉单支病变组(30例)、双支病变组(31例)和三支病变组(30例);CAG前1个月内完成24h动态心电图检查,计算心率变异时域指标SDNN、SDANN、SDNN Index、rMSSD和PNN50。结果:冠心病组心率变异指标(PNN50除外)明显低于对照组(均P<0.05);冠心病多支病变组心率变异指标(PNN50)明显低于对照组和单支病变组(均P<0.05)。所有病例的心率变异指标(PNN50除外)与反映冠脉病变严重度的冠脉病变支数、冠脉狭窄百分比、Gennisi评分存在明显的负相关关系(P<0.01)。结论:冠心病患者,心率变异(HRV)降低不仅与冠脉狭窄严重度有关,而且与冠脉病变的广泛程度有关,提示心肌缺血是冠心病患者HRV降低的重要因素,HRV降低程度对冠心病严重度可能有预测价值。

The relationship between CAD severity and heart rate variabilityin patients with coronary artery disease

Objective :To investigate the influence of coronary artery disease(CAD)severity to heart rate variability(HRV).Methods:Coronary angiography was completed in 130 patients suspected coronary artery disease and angiographic severity of coronary disease was quantitated by Gensini score.130 patients were divided to 4 groups:non-CAD group(39 patients),CAD group with only one coronary artery involved(CAD1 group,30 patients),CAD group with two coronary artery involved(CAD2 group,31 patients),CAD group with three coronary artery involved(CAD3 group,30 patients).A month before Coronary angiography,24 hours dynamic electrocardiogram had been accomplished,and time-domain HRV(SDNN、SDANN、SDNNIndex、rMSSD and PNN50)had been measured.Results:HRV(excepting PNN50)was significantly lower(all P<0.05)in CAD group than that in non-CAD group,and HRV was significantly lower(all P<0.05)in CAD2 group and CAD3 group than that in non-CAD group and CAD1 group.Meanwhile,there was a negative correlation(all P<0.01)between HRV parameters SDNN、SDANN、SDNNindex、 rMssd and Gennisiscore、the quantity of coronary artery involved、 the percentage of coronary artery stegnosis.Conclusion:The HRV decreasing was correlated tightly with the degree of coronary artery stegnosis and the quantity of coronary artery involved in CAD patients,it indicated that myocardial.ischemia was important cause for HRV decreasing,and CAD severity could be predicted possibly with the Lower HRV.