在特发性肺动脉高压成年患者中，心率变异性参数和室性心律失常与肺动脉压力相关。
Heart rate variability parameters and ventricular arrhythmia correlate with pulmonary arterial pressure in adult patients with idiopathic pulmonary arterial hypertension.
作者信息
Yi Hung-Tao, Hsieh Yu-Cheng, Wu Tsu-Juey, Huang Jin-Long, Lin Wei-Wen, Liang Kae-Woei, Su Chieh-Shou, Tsai Wan-Jane, Wang Kuo-Yang
机构信息
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine and Cardiovascular Research Institute, Department of Medicine, National Yang-Ming University, Taipei, Taiwan.
Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine and Cardiovascular Research Institute, Department of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Financial and Computational Mathematics, Providence University, Taichung, Taiwan.
出版信息
Heart Lung. 2014 Nov-Dec;43(6):534-40. doi: 10.1016/j.hrtlng.2014.05.010. Epub 2014 Jun 11.
OBJECTIVE
This aim of this study was to correlate heart rate variability (HRV) parameters to pulmonary arterial pressure (PAP) in patients with purely idiopathic pulmonary arterial hypertension (IPAH).
BACKGROUND
HRV is decreased in patients with PAH. Whether HRV indices can be used to assess PAP in IPAH patients remains unclear.
METHODS
HRV parameters obtained by 24-h ECG were evaluated in 26 IPAH patients and 51 controls.
RESULTS
Time-domain HRV parameters (SDNN, p < 0.0001; SDANN, p < 0.0001; RMSSD, p = 0.006) were lower in IPAH patients. Frequency-domain indices (high-frequency power, HFP, p = 0.001; low-frequency power, LFP, p = 0.003; total power, TP, p = 0.001) were also decreased in IPAH patients. In IPAH patients, RMSSD (p = 0.001), HFP (p = 0.015), and LFP (p = 0.027) were significantly correlated with PAP. IPAH patients had longer QTc intervals (p < 0.0001) and more premature ventricular contractions (p < 0.0001) than controls.
CONCLUSIONS
IPAH is associated with autonomic dysfunction. RMSSD, HFP, and LFP may be used as a supplemental tool to assess PAP in IPAH patients. IPAH patients with autonomic dysfunction are at high risk for ventricular arrhythmia.
目的
本研究旨在探讨单纯特发性肺动脉高压（IPAH）患者的心率变异性（HRV）参数与肺动脉压（PAP）之间的相关性。
背景
PAH患者的HRV降低。HRV指标是否可用于评估IPAH患者的PAP尚不清楚。
方法
对26例IPAH患者和51例对照者进行24小时心电图检测，评估HRV参数。
结果
IPAH患者的时域HRV参数（SDNN，p < 0.0001；SDANN，p < 0.0001；RMSSD，p = 0.006）较低。频域指标（高频功率，HFP，p = 0.001；低频功率，LFP，p = 0.003；总功率，TP，p = 0.001）在IPAH患者中也降低。在IPAH患者中，RMSSD（p = 0.001）、HFP（p = 0.015）和LFP（p = 0.027）与PAP显著相关。IPAH患者的QTc间期长于对照组（p < 0.0001），室性早搏多于对照组（p < 0.0001）。
结论
IPAH与自主神经功能障碍有关。RMSSD、HFP和LFP可作为评估IPAH患者PAP的补充工具。伴有自主神经功能障碍的IPAH患者发生室性心律失常的风险较高。
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