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首页> 外文期刊>Circulation journal >Prognostic significance of long-period heart rate rhythms in chronic heart failure
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Prognostic significance of long-period heart rate rhythms in chronic heart failure

机译：长周期心律对慢性心力衰竭的预后意义

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Background: Abnormalities in autonomic control are a feature of neuroendocrine activation in HF and are responsible for dysregulation of biological rhythms. The purpose was to investigate the presence and the prognostic significance of long-period heart rate (HR) rhythms in heart failure (HF) patients. Methods and Results: In the study, 92 HF patients were enrolled (age 53±14 years and left ventricular ejection fraction [LVEF] 37±10%). A rhythmometric analysis was used to assess the HR rhythms in 7-days (7D) Holter recordings. Rhythms properties were quantified by mesor and amplitude, in beats/min and by acrophase, in hours. Cardiac death or HF decompensation were registered. All patients had 24-h rhythm, 61 patients (77%) had 8-h rhythm, and 66 patients (83%) had 7D rhythm. Twelve patients (15%) experienced events. Among rhythm parameters only 7D median amplitude was different between patients with or without events: 1.1 beats/min [0.5-1.5] vs. 2.0 beats/min [0.0-3.9], P=0.049 respectively. After multivariate adjustment, LVEF (per 1%, hazard ratio 0.92, 95% confidence interval (CI) 0.87 to 0.98, P=0.01), N-terminal portion of pro-natriuretic hormone type B (per 100 pg/ml, hazard ratio 1.036, 95% CI 1.005-1.069, P=0.022), and 7D amplitude of the HR ≤1.71 beats/min (hazard ratio 5.4, 95% CI 1.2-34.4, P=0.047) were independent predictors of events. Conclusions: A 7D HR rhythm is present in most patients with HF, and has prognostic significance.
机译：背景：自主控制异常是心衰中神经内分泌激活的一个特征，是生物节律失调的原因。目的是研究心力衰竭（HF）患者长周期心律（HR）节律的存在及其对预后的意义。方法和结果：本研究共纳入92例HF患者（年龄53±14岁，左室射血分数[LVEF] 37±10％）。使用心律图分析来评估7天（7D）动态心电记录中的HR心律。节奏特性通过拍子和分钟（单位：拍/分钟）和前相（单位：小时）量化。记录心脏死亡或HF代偿失调。所有患者均具有24小时节律，61例患者（77％）具有8小时节律，66例患者（83％）具有7D节律。十二名患者（15％）经历了事件。在节奏参数中，有或没有事件的患者之间只有7D中值振幅有所不同：1.1次/分[0.5-1.5]与2.0次/分[0.0-3.9]，分别为P = 0.049。多变量调整后，LVEF（每1％，危险比0.92，95％置信区间（CI）0.87至0.98，P = 0.01），B型钠尿原激素的N端部分（每100 pg / ml，危险比1.036、95％CI 1.005-1.069，P = 0.022）和HR≤1.71节拍/分钟的7D振幅（危险比5.4、95％CI 1.2-34.4，P = 0.047）是事件的独立预测因子。结论：大多数HF患者均存在7D HR节律，并具有预后意义。

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