目的 探讨超高龄(≥80岁)持续性心房颤动(简称房颤)患者的心率变异性(HRV)与基础临床特征的关系。方法 选取108例超高龄持续性房颤患者纳入房颤组，另选取127例超高龄窦性心律老人纳入对照组，监测24 h动态心电图，比较2组心率、HRV时域指标[正常RR间期标准差(SDNN)、全程每5 min RR间期平均值的标准差(SDANN)、相邻NN间期差值的均方根(RMSSD)、全程记录中5 min NN间期标准差平均值(SDNN index)、心率变异指数(HRV index)和相邻NN间期差值＞50 ms的心搏数占NN间期总搏数的百分比(PNN50)]。收集房颤患者的基础临床特征，采用多元线性回归分析探讨HRV时域指标与心率、基础临床特征的相关性。结果 房颤组的SDNN、RMSSD、HRV index、PNN50、SDNN index均高于对照组，差异有统计学意义(P＜0。01)。多元线性回归分析结果显示，SDNN升高与高血压(P=0。001)、服用β受体阻滞剂(P=0。003)、心率慢(P＜0。001)显著相关，RMSSD升高与高血压(P=0。040)、服用β受体阻滞剂(P=0。002)、心率慢(P＜0。001)显著相关，HRV index升高与心力衰竭(P=0。003)、心率慢(P＜0。001)显著相关，PNN50升高与心率慢(P=0。004)显著相关;SDNN index升高与服用β受体阻滞剂(P=0。002)、心率慢(P＜0。001)显著相关，SDANN升高与高血压(P=0。006)、心率慢(P＜0。001)、服用达比加群(P=0。021)显著相关。结论 超高龄持续性房颤患者的HRV与基础临床特征存在相关性，该现象可能源于自主神经系统的活动状态。
Relationship between heart rate variability and baseline clinical characteristics in super-aged patients with persistent atrial fibrillation
Objective To investigate the relationship between heart rate variability(HRV)and baseline clinical characteristics in super-aged(≥80 years old)patients with persistent atrial fibrilla-tion(AF).Methods A total of 108 super-aged patients with persistent AF were included in AF group,and 127 super-aged patients with sinus rhythm were included in control group.24-hour ambu-latory electrocardiogram monitoring was conducted to compare heart rate and HRV time-domain indi-cators[standard deviation of normal RR intervals(SDNN),standard deviation of the average of nor-mal to normal intervals(SDANN)every 5 minutes throughout the recording,mean of the sum of the squares of differences between adjacent N-N intervals(RMSSD),average value of standard deviation of 5-minute NN intervals throughout the recording(SDNN index),heart rate variability(HRV)in-dex,and percentage of NN intervals with differences greater than 50 ms accounting for the total num-ber of NN intervals(PNN50)].Clinical characteristics of AF patients were collected,and multiple linear regression analysis was used to explore the correlation between HRV time-domain indicators and heart rate and baseline clinical characteristics.Results SDNN,RMSSD,HRV index,PNN50,and SDNN index were higher in the AF group than in the control group(P＜0.01).Multiple linear regression analysis showed that increased SDNN was significantly associated with hypertension(P=0.001),use of β-blockers(P=0.003),and slow heart rate(P＜0.001).Increased RMSSD wassignificantly associated with hypertension(P=0.040),use of β-blockers(P=0.002),and slow heart rate(P＜0.001).Increased HRV index was significantly associated with heart failure(P=0.003)and slow heart rate(P＜0.001).Increased PNN50 was significantly associated with slow heart rate(P=0.004).Increased SDNN index was significantly associated with the use of β-blockers(P=0.002)and slow heart rate(P＜0.001).Increased SDANN was significantly associated with hy-pertension(P=0.006),slow heart rate(P＜0.001),and use of dabigatran(P=0.021).Con-clusion There is a correlation between HRV and baseline clinical characteristics in super-aged pa-tients with persistent AF,which may be due to the activity status of the autonomic nervous system.
万方数据
维普
