Sosnowski Maciej, Kozakiewicz Krystyna, Korzeniowska Barbara, Tendera Michał
III Katedry i Kliniki Kardiologii, Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2002;55(9-10):561-8.
The results of HRV analysis in patients with hypertrophic cardiomyopathy (HCM) are conflicting. We evaluated short-term HRV in patients with familiar HRV and in their close relatives. 31 families of patients with HCM were examined. There were 43 patients with HCM confirmed by 2D-echo (HCM-group, 23 f, 20 m, aged 46 +/- 14 ys), and 157 family members (REL-group, 75 f, 82 m, aged 29 +/- 17 ys). The control group consisted of 180 healthy subjects (80 f, 100 m, aged 33 +/- 12 ys). In each subject 512 consecutive sinus beats were recorded in supine position during spontaneous breathing using computer-assisted amplifier (A/D 12 bit, 1 kHz). Mean RR interval (RRI, ms), its standard deviation (SDRR, ms) and spectral measures (FFT, Blackman-Harris window): PSD of high frequency (HF) and low frequency (LF) [ms2/Hz], as well as respiratory rate (BPM) were measured. Patients with HCM had significantly shorter RRI (867 +/- 121) as compared to the controls (919 +/- 138, p < 0.05). The RRI was also shorter in the relatives (851 +/- 150, p < 0.01). In HCM and REL groups the respiratory rate was faster (16.7 +/- 3.0 and 17.1 +/- 3.4, respectively), as compared to the controls (14.5 +/- 2.9, both p < 0.01). The HRV measures were reduced in the HCM-group (SDRR 31.4 +/- 10.6, lnHF 7.71 +/- 0.65, lnLF 8.22 +/- 0.65 and LF/HF 1.07 +/- 0.10), as compared to the controls (SDRR 64.8 +/- 23.9, lnHF 8.79 +/- 0.61, lnLF 8.87 +/- 0.65, all p < 0.001 and LF/HF 1.01 +/- 0.07, p < 0.01). In the REL-group SDRR and lnHF were significantly reduced (SDRR 52.4 +/- 24.1, lnHF 8.48 +/- 0.78, p < 0.001), while the remaining parameters were comparable. The HRV reduction was more expressed in HCM-patients and family-members < 30 years of age. A significantly reduced age-, sex- and RRI-adjusted SDNN was observed in 54% pts in HCM-group and in 42% subjects in members-group. Reduced heart rate variability is frequently seen not only in patients with diagnosed HCM, but also in a substantial number of their kindred.
肥厚型心肌病(HCM)患者心率变异性(HRV)分析的结果存在争议。我们评估了家族性HRV患者及其近亲的短期HRV。对31个HCM患者家庭进行了检查。有43例经二维超声心动图确诊的HCM患者(HCM组,23例女性,20例男性,年龄46±14岁),以及157名家庭成员(亲属组,75例女性,82例男性,年龄29±17岁)。对照组由180名健康受试者组成(80例女性,100例男性,年龄33±12岁)。使用计算机辅助放大器(A/D 12位,1 kHz)在仰卧位自发呼吸期间记录每个受试者连续512次窦性搏动。测量平均RR间期(RRI,毫秒)、其标准差(SDRR,毫秒)和频谱测量值(快速傅里叶变换,布莱克曼 - 哈里斯窗):高频(HF)和低频(LF)的功率谱密度[毫秒²/赫兹],以及呼吸频率(每分钟心跳次数)。与对照组(919±138,p<0.05)相比,HCM患者的RRI显著缩短(867±121)。亲属组的RRI也较短(851±150,p<0.01)。与对照组(14.5±2.9,p均<0.01)相比,HCM组和亲属组的呼吸频率更快(分别为16.7±3.0和17.1±3.4)。与对照组(SDRR 64.8±23.9,lnHF 8.79±0.61,lnLF 8.87±0.65,均p<0.001和LF/HF 1.01±0.07,p<0.01)相比,HCM组的HRV测量值降低(SDRR 31.4±10.6,lnHF 7.71±0.65,lnLF 8.22±0.65和LF/HF 1.07±0.10)。在亲属组中,SDRR和lnHF显著降低(SDRR 52.4±24.1,lnHF 8.48±0.78,p<0.001),而其余参数相当。HRV降低在年龄<30岁的HCM患者和家庭成员中表现得更为明显。在HCM组中,54%的患者以及在亲属组中42%的受试者观察到年龄、性别和RRI校正后的SDNN显著降低。心率变异性降低不仅常见于已确诊的HCM患者,也见于其大量亲属。