原发性高血压患者左心室肥厚与室性心律失常及心率变异性的关系

为探讨原发性高血压患者左心室肥厚与室性心律失常及心率变异性的关系。将原发性高血压患者分为无左心室肥厚组和左心室肥厚组，通过心脏B超观察原发性高血压患者心脏的结构与功能，通过动态心电图观察其24h室性期前收缩情况及心率变异性各时域指标。结果发现，左心室肥厚组患者的24h室性期前收缩发生率及室性期前收缩级别明显高于无左心室肥厚组（P＜0．01）；两组患者心率变异性各指标差异无显著性（P＞0．05）；与室性期前收缩级别相关的独立危险因素依次为室间隔厚度、左心室舒张末期内径和患者的年龄（P＜0．05，P＜0．001，P＜0．05）。以上提示原发性高血压合并左心室肥厚患者严重室性心律失常的发生率明显增高，而左心室肥厚与心率变异性无相关性。室间隔厚度、左心室舒张末期内径与年龄是原发性高血压患者发生室性心律失常的独立危险因素。

The Relationship of Left Ventricle Hypertrophy, Ventricular Arrhythmia and Heart Rate Variability in Patients with Essential Hypertension

Aim To explore the relationship of left-ventricle hypertrophy (LVH), ventricular arrhythmia and heart rate variability (HRV) in patients with essential hypertension(EH). Methods A total of 94 patients were divided into two groups: EH without LVH (control group, n=47), and EH with LVH (LVH group, n=47). The structure and function of hearts were observed through cardio B-ultrasound. The ventricular premature beats and the parameters of HRV in every time-span were observed through 24 hours holter monitoring electrocardiogram. Results Both of the incidence and grades of ventricular premature beats for 24 hours in LVH group are obviously higher than that in control group (P=0.000). The parameters of HRV were not significantly different between two groups (P>0.05). The independent risks of the grades of ventricular premature beats are the interventricular septum (IVS) thickness, the left ventricular end-diastolic dimension (LVDd) and age of patients (P<0.05, P<0.001, P<0.05; respectively). Conclusion The incidence of severe ventricular arrhythmia in EH patients with LVH raises obviously, but no correlativity exists between LVH and HRV. IVS, LVDd, and age are the independent risk factors of ventricular arrhythmia in EH patients.