心率变异性与冠状动脉病变的关系

目的探讨心率变异性(heartratevariability,HRV)与冠状动脉病变范围和程度的关系。方法回顾性分析我院冠心病患者186例的冠状动脉病变范围程度和HRV指标。用Logistic回归筛选冠状动脉病变的HRV预测指标。结果HRV时域指标和频域指标均随冠状动脉病变范围和程度的加重而降低,时域指标,包括正常窦性心搏间期标准差(standarddeviationofnormalnumberofintervals,SDNN),每5分钟平均正常窦性心搏间期标准差(standarddeviationofper5minaveragesnormalnumberofintervals,SDANN),正常窦性心搏间期标准差平均值(averageofstandarddeviationofnormalnumberofintervals,ASDNN),相邻正常窦性心搏间期差的平方根值(rootmeansquarevaluesofthestandarddeviationbetweenadjacentnormalnumberofintervals,rMSSD),相邻正常窦性心搏间期差超过50ms的个数占总窦性心搏数的百分率(percentageofdifferencesexceeding50msbetweenadjacentnormalnumberofintervalsPNN50),PNN50包括PNN50a(大于相邻心搏间期50ms)和PNN50b(小于相邻心搏间期50ms),频域指标包括低频带(lowfrequency,LF),极低频带(verylowfrequency,VLF),高频带(highfrequency,HF)都与冠状动脉病变范围和程度呈负相关(P<0.01或P<0.05);Logistic回归结果表明SDANN、LF/HF为冠状动脉病变范围和程度的保护因素。结论有冠状动脉病变的患者HRV降低,存在自主神经功能紊乱;HRV与冠状动脉病变范围和程度呈负相关。

The correlation between heart rate variability and coronary artery lesion

Objectives To analyze the correlation between heart rate variability (HRV) and the extent and severity of coronary artery lesion. Methods 186 patients with coronary heart disease were selected. cases were reviewed, and the correlation between HRV and the extent and severity of coronary artery lesion were analyzed. HRV indices to forecast coronary artery lesion were screened out by stepwise multinomial ordinal logistic regression. Results Both time and frequency domain indices had a decreasing trend with the extent and severity of coronary artery lesion. There were weak negative correlation between HRV (including SDNN, SDANN, ASDNN, rMSSD, PNN50, PNN50a, PNN50b of time domain indices and LF, VLF, HF of frequency domain indices) and the extent and severity of coronary artery lesion with statistic significance(P<0.01 or P<0.05). The results of logistic regression indicated that SDANN and LF/HF were protective factors. Conclusions Patients with coronary artery lesion have decreased HRV indicating malfunction of cardiac automatic nervous system. There was weak negative correlation between HRV and the extent and severity of coronary artery lesion.