Szydlo Krzysztof, Orszulak Witold, Trusz-Gluza Maria, Tabor Zbigniew, Wita Krystian, Orszulak Michal, Marzec Michal, Kniewska-Jarzabek Katarzyna, Grabka Marek
Department of Cardiology, Medical University of Silesia, Katowice, Poland.
J Electrocardiol. 2011 Mar-Apr;44(2):142-7. doi: 10.1016/j.jelectrocard.2010.12.006.
In the study, there has been retrospectively analyzed heart rate turbulence in postinfarction patients. The cohort of 158 patients consisted of 94 patients with documented ventricular tachycardia and/or ventricular fibrillation (VT/VF) and 64 patients without history of VT/VF. Turbulence onset and slope were calculated from Holter recordings, and left ventricle ejection fraction (LVEF) ≤35% was regarded as severe left ventricle dysfunction. Study groups were similar in age and sex. Left ventricle ejection fraction was lower in the VT/VF group (P < .005). Patients with VT/VF had higher turbulence onset (-0.22% ± 1% vs -0.8% ± 2%; P = .005) and lower turbulence slope (2.6 ± 1.9 vs 4.1 ± 3.5 milliseconds per RR interval; P = .01). These trends were observed in patients with LVEF >35% but not in subjects with LVEF ≤35%. Diabetes mellitus, previous coronary artery bypass graft, and amiodarone therapy have diminished the intergroup differences significantly.
Heart rate turbulence is diminished in postinfarction patients with a history of malignant ventricular arrhythmias. It seems to separate subjects at arrhythmic risk among patients with relatively preserved left ventricle function, but it is diminished in patients with previous coronary artery bypass graft, diabetes, and amiodarone therapy.
在该研究中，对心肌梗死后患者的心率震荡进行了回顾性分析。158例患者的队列包括94例有记录的室性心动过速和/或心室颤动（VT/VF）患者以及64例无VT/VF病史的患者。根据动态心电图记录计算震荡起始和斜率，左心室射血分数（LVEF）≤35%被视为严重左心室功能障碍。研究组在年龄和性别方面相似。VT/VF组的左心室射血分数较低（P <.005）。VT/VF患者的震荡起始较高（-0.22%±1%对-0.8%±2%；P =.005）且震荡斜率较低（每RR间期2.6±1.9对4.1±3.5毫秒；P =.01）。这些趋势在LVEF>35%的患者中观察到，但在LVEF≤35%的患者中未观察到。糖尿病、既往冠状动脉旁路移植术和胺碘酮治疗显著减小了组间差异。
有恶性室性心律失常病史的心肌梗死后患者心率震荡减弱。在左心室功能相对保留的患者中，它似乎能区分有心律失常风险的患者，但在既往有冠状动脉旁路移植术、糖尿病和胺碘酮治疗的患者中减弱。
