Flevari Panayota, Georgiadou Panagiota, Leftheriotis Dionyssios, Livanis Efthimios, Theodorakis George, Th Kremastinos Dimitrios
Second Department of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece.
Pacing Clin Electrophysiol. 2007 Jun;30(6):787-95. doi: 10.1111/j.1540-8159.2007.00751.x.
Heart rate turbulence (HRT) following isolated premature complexes is a baroreceptor-mediated prognostic marker. Short runs of spontaneous, nonsustained ventricular tachycardia (nsVT) exert a greater hemodynamic effect than extrasystoles and may trigger a more potent turbulence-like response (HRT(VT)), possibly related to other risk-related markers, such as heart rate variability (HRV), left ventricular ejection fraction (EF), and original HRT parameters (turbulence slope [TS] and turbulence onset [TO]).
We studied 27 patients with heart failure (HF) and nsVT (4-7 beats) on 24-hour Holter electrocardiographic recordings (mean age 58 +/- 3.6 years, EF 36%+/- 5.0%). Following nsVT, TS(VT) and TO(VT) were measured according to the original definitions. HRV, TS, and TO were also assessed.
HRT(VT) parameters were related to HRV. A significant relation existed between TS(VT) and EF (r= 0.66, P < 0.05). HRT(VT) parameters were related to the originally described (TS and TO), whereas TO(VT) was higher than TO (1.63 +/- 1.6 vs -1.7 +/- 0.65, P < 0.05).
In mild-to-moderate HF, turbulence is observed following short nsVT runs and is related to prognostically important HRV indexes and EF. HRT(VT) is similar to HRT but TO(VT) is shifted toward more positive values than TO. HRT(VT) might be prognostically significant.
孤立性早搏后的心率震荡（HRT）是一种压力感受器介导的预后标志物。短阵自发性非持续性室性心动过速（nsVT）比期外收缩具有更大的血流动力学效应，可能引发更强烈的类似震荡的反应（HRT(VT)），这可能与其他风险相关标志物有关，如心率变异性（HRV）、左心室射血分数（EF）以及原始HRT参数（震荡斜率[TS]和震荡起始[TO]）。
我们对27例心力衰竭（HF）合并nsVT（4 - 7次搏动）患者进行了24小时动态心电图记录研究（平均年龄58±3.6岁，EF 36%±5.0%）。在nsVT后，根据原始定义测量TS(VT)和TO(VT)。同时也评估了HRV、TS和TO。
HRT(VT)参数与HRV相关。TS(VT)与EF之间存在显著相关性（r = 0.66，P < 0.05）。HRT(VT)参数与最初描述的参数（TS和TO）相关，而TO(VT)高于TO（1.63±1.6对 -1.7±0.65，P < 0.05）。
在轻至中度HF患者中，短阵nsVT后可观察到震荡，且与具有预后意义的HRV指标和EF相关。HRT(VT)与HRT相似，但TO(VT)比TO向更正值偏移。HRT(VT)可能具有预后意义。
