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冠状动脉扩张症和冠状动脉疾病患者心率变异性的评估

Evaluation of heart rate variability in patients with coronary artery ectasia and coronary artery disease.

作者信息

Yıldız Bekir Serhat, Özkan Emel, Esin Fatma, Özkan Hayrettin, Alihanoğlu Yusuf İzzettin, Kılıç İsmail Doğu, Evrengül Harun, Kaftan Havane Asuman

机构信息

Department of Cardiology, Pamukkale University Faculty of Medicine, Denizli, Turkey.

Department of Cardiology, İzmir Atatürk Training and Research Hospital, İzmir, Turkey.

出版信息

Turk Kardiyol Dern Ars. 2016 Jun;44(4):306-14. doi: 10.5543/tkda.2015.84899.

Abstract

OBJECTIVE

The present study compared heart rate variability (HRV) parameters in patients with coronary artery ectasia (CAE) and coronary artery disease (CAD).

METHODS

The study population consisted of 60 consecutive patients with CAE (14 women; mean age 51.63±7.44 years), 60 consecutive patients with CA (15 women; mean age 53.67±9.31 years), and 59 healthy individuals (13 women; mean age 52.85±8.19 years). Electrocardiograms, 24-hour Holter analyses, and routine biochemical tests were performed, and clinical characteristics were evaluated. Coronary angiography images were analyzed. Time-domain HRV parameters, including the standard deviation (SD) of normal-to-normal intervals (SDNN) and the root mean square of difference in successive normal-to-normal intervals (RMSSD) were evaluated, as were frequency-domain HRV parameters including low-frequency (LF), very low-frequency (VLF), high-frequency (HF), the proportion derived by dividing low- and high-frequency (LF/HF), and total power (TP).

RESULTS

SDNN was lower in both the CAE and CAD groups, compared to the healthy group (140.85±44.21, 96.51±31.28, and 181.05±48.67, respectively). A significant difference in RMSSD values among the groups was determined (p=0.004). Significantly decreased VLF and HF values were found in the CAE group, compared with the healthy group (VLF p<0.001; HF, p=0.007). TP, VLF, and HF values were significantly lower (p<0.001, p<0.001, and p<0.001, respectively), but LF and LF/HF values were significantly higher (p<0.001 for both) in the CAD group than in the healthy group. TP values were significantly higher (p<0.001), and LF and LF/HF values were lower in the CAE group, compared with the CAD group (p<0.001 for both).

CONCLUSION

A decrease in vagal modulation or an increase in sympathetic activity of cardiac function, assessed by HRV analysis, is worse in patients with CAD than in patients with CAE.

摘要

目的

本研究比较了冠状动脉扩张(CAE)患者和冠状动脉疾病(CAD)患者的心率变异性(HRV)参数。

方法

研究人群包括60例连续的CAE患者(14例女性;平均年龄51.63±7.44岁)、60例连续的CAD患者(15例女性;平均年龄53.67±9.31岁)和59名健康个体(13例女性;平均年龄52.85±8.19岁)。进行了心电图、24小时动态心电图分析和常规生化检查,并评估了临床特征。对冠状动脉造影图像进行了分析。评估了时域HRV参数,包括正常RR间期标准差(SDNN)和相邻RR间期差值的均方根(RMSSD),以及频域HRV参数,包括低频(LF)、极低频(VLF)、高频(HF)、低频与高频比值(LF/HF)和总功率(TP)。

结果

与健康组相比,CAE组和CAD组的SDNN均较低(分别为140.85±44.21、96.51±31.28和181.05±48.67)。确定各组间RMSSD值存在显著差异(p = 0.004)。与健康组相比,CAE组的VLF和HF值显著降低(VLF,p < 0.001;HF,p = 0.007)。CAD组的TP、VLF和HF值显著较低(分别为p < 0.001、p < 0.001和p < 0.001),但LF和LF/HF值显著较高(两者均为p < 0.001)。与CAD组相比,CAE组的TP值显著较高(p < 0.001),而LF和LF/HF值较低(两者均为p < 0.001)。

结论

通过HRV分析评估,CAD患者心脏功能的迷走神经调节降低或交感神经活动增加比CAE患者更严重。

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