Dynamic electrocardiogram features of patients with chronic pulmonary heart disease during the compensated versus decompensated phases of heart function
Objective To compare the dynamic electrocardiogram(DCG)features of patients with chronic pulmonary heart disease(CPHD)during the compensated versus decompensated phases of heart function.Methods A retrospective analysis was conducted on the clinical data of 116 patients with CPHD admitted to Xi'an People's Hospital(Xi'an Fourth Hospital)from October 2020 to October 2023.These patients were divided into two groups based on heart function status:62 patients in the compensated group(control group)and 54 patients in the decompensated group(observation group).All patients underwent DCG examinations.The ST segment changes,occurrence of arrhythmias,heart rate variability indicators(root mean square of successive RR interval differences,standard deviation of normal-to-normal RR intervals,and standard deviation of the average normal-to-normal intervals),and heart rate turbulence indicators(turbulence onset,turbulence slope,and turbulence dynamicity)were compared between the two groups.Results Compared with the control group,the observation group exhibited a higher rate of ST segment elevation[16.67％(9/54)vs.3.23％(2/62),x2=6.07,P=0.014],as well as a higher rate of ST segment depression[83.33％(45/54)vs.40.32％(25/62),x2=22.31,P＜0.001].Additionally,the observation group had a longer duration of ST segment depression[(22.35±6.34)minutes vs.(17.76±5.24)minutes,t=3.07,P=0.003],a greater amplitude of ST segment depression[(0.26±0.14)mV vs.(0.16±0.09)mV,t=3.21,P=0.002],and a greater amplitude of ST segment elevation[(0.31±0.08)mV vs.(0.15±0.06)mV,t=2.62,P=0.027].There was no statistically significant difference in the duration of ST segment elevation between the two groups(P＞0.05).Compared with the control group,the observation group had a higher incidence of sinus bradycardia,paroxysmal ventricular tachycardia,premature ventricular contractions,and atrial fibrillation[33.33％(18/54)vs.14.52％(9/62),x2=5.72,P=0.017;14.81％(8/54)vs.1.61％(1/62),x2=7.02,P=0.008;61.11％(33/54)vs.20.97％(13/62),x2=19.43,P＜0.001;12.96％(7/54)vs.1.61％(1/62),x2=5.79,P=0.016].However,the differences in the incidence of atrial premature contractions,atrioventricular block,and accelerated idioventricular rhythm were not statistically significant between the two groups(all P＞0.05).Compared with the control group,the observation group exhibited lower values for standard deviation of normal-to-normal RR intervals[(41.36±10.72)ms vs.(72.25±21.36)ms,t=9.62,P＜0.001],standard deviation of the average normal-to-normal intervals[(41.36±12.17)ms vs.(74.36±21.28)ms,t=10.05,P＜0.001],and TS[(5.31±3.27)ms/RRI vs.(6.86±4.14)ms/RRI,t=2.21,P=0.028].Compared with the control group,the observation group showed higher values for turbulence dynamicity[(0.09±0.03)ms/bpm vs.(0.06±0.02)ms/bpm,t=6.40,P＜0.001]and turbulence onset[(0.94±0.73)％vs.(0.66±0.77)％,t=2.00,P=0.047].There was no statistically significant difference in root mean square of successive RR interval differences between the two groups(P＞0.05).Conclusion DCG is an effective tool for monitoring cardiac function in patients with CPHD.Notably,patients in the decompensated stage of heart function exhibit significant ST segment changes,along with an increased incidence of premature ventricular contractions and sinus bradycardia.DCG can effectively assess the clinical condition of these patients,providing effective evidence for subsequent diagnosis and treatment.
Pulmonary heart diseaseHeart function testsElectrocardiography,ambulatoryArrhythmias,cardiacheart rate
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