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目的分析冠状动脉 (CA)病变与室壁运动功能及心率变异 (HRV)的关系 ,探讨侧支循环对CA病变与室壁运动功能及心率变异 (HRV)之间关系的影响。方法对 93例CA病变 (狭窄≥ 70 % )患者作Leaman记分 ,左室壁运动功能作Cortina记分和HRV时阈分析。结果全组 93例中CA记分与左室壁运动功能记分呈弱相关 (r =0 .2 6 ,P <0 .0 5 )。在NCC组中 ,CA记分与左室壁运动功能记分呈密切正相关 (r=0 .5 4 ,P <0 .0 1)。全组 93例的CA记分与HRV各项指标无相关。而在NCC组中 ,CA记分与HRV的SDNN、DNNI、rMSSD和PNN 5 0呈负相关 (r分别为 - 0 .4 5 ,- 0 .4 2 ,- 0 .34和 - 0 .33,P <0 .0 1或 0 .0 5 )。结论CA的病变程度与左室壁运动功能及HRV的关系取决于病变的CA有无侧支循环 ,而侧支循环对CA病变患者的左室壁运动功能和心脏自主神经功能有保护作用。
Objective To analyze the relationship between coronary artery (CA) lesions and wall motion function and heart rate variability (HRV) and to explore the influence of collateral circulation on the relationship between CA lesions and wall motion function and heart rate variability (HRV). Methods 93 patients with CA lesions (stenosis ≥ 70%) were evaluated by Leaman score, left ventricular wall motion function as Cortina score and HRV threshold analysis. Results The score of CA in 93 patients was weakly correlated with left ventricular wall motion score (r = 0.26, P <0.05). In the NCC group, CA score was positively correlated with left ventricular wall function score (r = 0.54, P <0.01). All 93 patients with CA score and HRV no correlation between the indicators. In the NCC group, the CA score was negatively correlated with SDNN, DNNI, rMSSD and PNN50 of HRV (r = -0.45, -0.42, -0.34 and -0.33, P <0 .0 1 or 0 .0 5). Conclusions The relationship between the severity of CA and left ventricular wall motion and HRV depends on whether the lesion has collateral circulation. Collateral circulation may have a protective effect on left ventricular wall motion and cardiac autonomic nerve function in CA patients.