心率震荡对慢性心力衰竭患者预后的预测价值

目的探讨心率震荡(HRT)对慢性心力衰竭(CHF)患者预后的预测价值。方法观察记录104例CHF患者和30例正常对照者的HRT(TO和TS)、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、静息心率(RHR)、SDNN,随访6～18个月,终点事件是患者心力衰竭恶化入院、心源性死亡。结果单变量分析结果表明,年龄≥65岁、LVEF≤30%、SDNN≤100 ms、RHR≥75次/min、HRT 1、HRT 2等6个变量对终点事件有预测价值,其中HRT 2具有最强的预测意义(RR=5.40,P<0.05);多变量分析结果显示LVEF≤30%(RR=4.68,P<0.05)、RHR≥75次/min(RR=3.18,P<0.05)、SDNN≤100 ms(RR=3.69,P<0.05)、HRT 2(RR=5.12,P<0.05)为仅有的4个对终点事件有预测价值的变量。结论 HRT是心功能Ⅱ～Ⅳ级心力衰竭患者一个有力的预后预测凶子。

The prognostic value of heart rate turbulence in patients with chronic heart failure

Objective To evaluate the prognostic significance of heart rate turbulence(HRT) for predicting readmission and mortality rate in chronic heart failure(CHF) patients in NYHA classⅡ~Ⅳ.Methods 104 patients with CHF’ and 30 normal controls were enrolled in present study,HRT(TO and TS),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),resting heart rate(RHR),SDNN were recorded.Patients were followed up for 6～18 months,the end point were readmission and cardiac death.Results Univariate analysis showed that age≥65 years,LVEF≤30%,SDNN≤100ms,RHR≥75bpm,HRT1,HRT2 could predict the end point,HRT2 was the strongest predictor(RR= 5.40,P<0.05);Multivariate analysis showed that only LVEF≤30%(RR=4.68,P<0.05),RHR≥75bpm(RR= 3.18,P<0.05),SDNN≤100 ms(RR=3.69,P<0.05) and HRT2(RR=5.12,P<0.05) had prognostic value to the end point.Conclusion HRT is a powerful predictor for heart failure in CHF patients with classⅡ~Ⅳ.