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目的:通过对扩张型心肌病(dilated cardiomyopathy,DCM)患者窦性心率震荡(heart rate turbulence,HRT)现象的分析,观察此类患者HRT与左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末期内径(left ventricular end diastolicdiameter,LVED)、室性期前收缩联律间期、代偿间期、24 h室性期前收缩数目的相关性。方法:对36例DCM患者和36例健康对照组分别进行24 h动态心电图(Holter)检查,分别得出震荡起始(TO)、震荡斜率(TS)值、24 h室性期前收缩数目、室性期前收缩联律间期和代偿间期,并同时获取超声心动图检测的LVEF、LVED,并进行TO、TS与LVEF、LVED的相关分析。结果:DCM患者TO明显高于对照组;TS明显低于对照组;TS与LVEF存在正相关,与LVED、24 h室性期前收缩数目存在负相关;TO与LVEF存在负相关,与LVED存在正相关;两者与联律间期、代偿间期不相关。结论:DCM患者HRT明显减弱,TO、TS对于DCM等的危险分层具有一定的临床意义。
OBJECTIVE: To investigate the relationship between HRT and left ventricular ejection fraction (LVEF) in patients with dilated cardiomyopathy (DCM) by analyzing the heart rate turbulence (HRT) Left ventricular end diastolic diameter (LVED), ventricular systolic interventricular septum, compensatory interval, 24 h ventricular premature contraction number of correlation. Methods: The dynamic electrocardiogram (Holter) examination was performed on 36 patients with DCM and 36 healthy controls, respectively. The initial values of TO, the mean value of TS, the number of premature ventricular contractions 24 h, Ventricular contraction systolic and inter-systolic and inter-ventricular systolic intervals, and at the same time to obtain echocardiography detected LVEF, LVED, and TO, TS and LVEF, LVED correlation analysis. Results: The TO in DCM patients was significantly higher than that in control subjects; TS was significantly lower than that in control subjects; TS was positively correlated with LVEF, negatively correlated with LVED and 24 h premature ventricular contractions; TO was negatively correlated with LVEF and LVED Positive correlation; both with the law interval, compensation interval is not relevant. Conclusion: The HRT of patients with DCM is obviously weakened. TO and TS have certain clinical significance for the risk stratification of DCM and so on.