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目的研究慢性充血性心力衰竭(CHF)病人24h动态心电图(24hDCG)恶性室性心律失常与心率震荡(HRT)的关系,以及缬沙坦干预后HRT的变化。方法选择有室性早搏的病人62例,分为CHF组(27例)和正常对照组(35例),所有病人均行24h动态心电图监测,计算心率震荡的初始值(TO)、震荡斜率(TS);CHF病人在常规治疗基础上加用缬沙坦口服1月后复查24hDCG监测。结果正常对照组TO<0,而CHF组TO>0;CHF组的TS明显低于正常对照组。CHF患者口服缬沙坦1个月前后对比,HRT有明显改善:TO下降,TS升高。结论HRT降低可以做为预测CHF恶性室性心律失常发生的指标;缬沙坦能改善CHF的自主神经功能,从而改善HRT,减少恶性室性心律失常的发生。
Objective To study the relationship between 24h ambulatory electrocardiogram (24hDCG) ventricular arrhythmia and heart rate turbulence (HRT) in patients with chronic congestive heart failure (CHF) and the change of HRT after valsartan intervention. Methods Sixty-two patients with ventricular premature beats were selected and divided into CHF group (n = 27) and normal control group (n = 35). All patients underwent 24-hour dynamic electrocardiogram monitoring to calculate the initial values of heart rate turbulence (TO) TS); CHF patients on the basis of conventional treatment plus oral valsartan 24h after 24 hours of re-examination of DCG monitoring. Results The normal control group TO <0, CHF group TO> 0; CHF group TS was significantly lower than the normal control group. HR patients with valsartan 1 month after the comparison, HRT improved significantly: TO decreased, TS increased. Conclusions The decrease of HRT can be used as an index to predict the occurrence of malignant ventricular arrhythmia in CHF. Valsartan can improve the autonomic nervous function of CHF, so as to improve HRT and reduce the incidence of malignant ventricular arrhythmia.