慢性充血性心力衰竭患者心率变异性分析

为探讨心力衰竭（ＣＨＦ）患者心率变异性（ＨＲＶ）的变化规律及其病理生理机制，本文采用时域及频域两种分析方法，对９２例ＣＨＦ患者５１例健康人进行了ＨＲＶ对比分析，并对部分患者进行血浆儿茶酚胺（ＮＥ、Ｅ）浓度测定及ＨＲＶ随访。发现：健康人及ＣＨＦ患者的ＨＲＶ有明显的昼夜变化规律，夜间ＨＲＶ〉白天：ＣＨＦ患者的ＨＲＶ明显低于健康组，且与病情及心功能明显相关，近期死亡者ＨＲＶ降低更加明显；血浆ＮＥ及Ｎ浓度

Analysis of heart rate variability in patientswith congestive heart failure

To study the variance rules and the mechanism of pathophysiology ofheart rate variability (HRV) in patients with congestive heart failure (CHF), in thepresent study HRV was assessed in 92 patients with CHF and 51 normal subjects as con-trols. HRV was analysed with a Holter analysis system, in the time domain and fre-quency domain. The concentration of catecholamines in plasma and HRV have been fol-lowed up in some patients. It was found that: (1) HRV of nomal subjects and CHFgroup had a definite circadian variation. The HRV was higher in night than day time.(2) HRV was significantly lower in the CHF group than in controls and definite relatedto NYHAFC in the CHF group. (3) HRV of the deaths in the near future of CHF groupdecreased more significantly. (4)The concentrations of NE and E were greatly higher inCHF group than control group. Therefore, HRV of patients with CHF is significantlydiminished comparing with normal subjects. These reasults suggest that both vagal toneand sympathetic activition of heart are impaired. The changes of HRV in patients withCHF correspond to the severity of the clinical condition. High concentration of adrenlinecan indirectly explain that the impairment of autonomic nervous activity in heart is theresult of the sustained activation of endogenous neurohoronal systems.