【摘要】 目的 探讨心率减速力(DC)对急性心肌梗死(AMI)患者发生心脏性猝死(SCD)的预警能力及其与心率变异性(HRV)的相关性。方法 选择208例AMI患者,于心肌梗死后1周进行动态心电图检测,并计算出DC值和HRV时域指标值。平均随访24个月,主要终点事件为SCD,次要终点事件为心源性死亡。进行队列研究DC和HRV与SCD关联的相对危险度分析,并进行二分类的Logistic多因素回归统计分析。结果共有12例患者发生SCD(5.7%),其DC值明显减低,相对危险度值为4.2(P=0.0054<0.01)。DC与HRV指标SDNN、SDANN、ASDNN、TI、RMSSD及PNN50的相关系数分别为0.5840、0.4346、0.8510、0.6081、0.5210、0.5028(P<0.001)。结论 DC对AMI后发生SCD有较强的预警作用,DC与HRV有较好的相关性。更多还原

【Abstract】 Objective To investigate the predictive value of sudden cardiac death(SCD) after acute myocardial infarction by deceleration capacity(DC) of heart rate and the relationship of DC with heart rate variability(HRV).Methods We enrolled 208 patients with an acute myocardial infarction and performed 24-hour ECG recordings within one week after admission to calculate DC and time domain measures of HRV.Patients were followed-up by 24 months in average or by the primary endpoints(sudden cardiac death) and secondary endpoints(all cause death).We tested the predictive value of DC by statistical analysis of multivariate logistic regression.Results SCD occurred in 12 patients(5.7%) and the patients of SCD had significantly lower DC;the relative risk was 4.2(P =0.0054 <0.01).The correlation coefficient between DC and SDNN,SDANN,ASDNN,TI,RMSSD and PNN50 were 0.5840,0.4346,0.8510,0.6081,0.5210 and 0.5028(P < 0.001),respectively.Conclusion Deceleration capacity of heart rate is a powerful predictor of SCD after myocardial infarction and it strongly correlated with HRV.更多还原