| Citation: |
LI Yefei, QIAN Yesheng, ZHENG Koulong, SHENG Zhenqiang, LU Huihe. Correlation between heart rate turbulence and the prognosis in heart failure patients with preserved ejection fraction[J]. Journal of Clinical Medicine in Practice, 2022, 26(24): 107-111. DOI: 10.7619/jcmp.20222255
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To investigate the relationship between heart rate turbulence(HRT) and the prognosis in heart failure patients with preserved ejection fraction(HFpEF).
A total of 291 patients with HFpEF were selected as study objects(during 2-year follow-up, 11 cases were lost and 280 cases were included). The turbulence onset (TO) and turbulence slope (TS) from the results of the holter electrocardiogram were calculated. According to the presence or absence of HRT, the patients were divided into observation group and control group, and the general information were compared. The occurrence of adverse cardiovascularevents, such as chest pain, cardiac insufficiency, atrial fibrillation, and non-persistent ventricular tachycardia as well as re-hospitalization and death were compared between the two groups during follow-up.
There was no significant difference between the two groups in general information (P>0.05). There were 117(41.79%) patients with abnormal TO (TO ≥ 0) and 25 patients (8.93%)with TS abnormality (TS ≤ 2.5ms/RR interval), while 13 patients with both abnormality of TO and TS. The ratio of abnormality of TO was higher than that of TS(P < 0.05). No death occurred during the follow-up period in the two groups, and the incidencerates of cardiovascular events such as chest pain, atrial fibrillation, cardiac insufficiency, non-sustained ventricular tachycardia and the rate of rehospitalization in the observation group were higher than those in the control group (P < 0.05). Correlation analysis showed that HRT was negatively correlated with cardiovascular adverse events and re-hospitalization (P < 0.05).
HRT phenomenon is correlated with the prognosis of HFpEF patients, and the reduction or disappearance of HRT phenomenon has certain predictive value for the occurrence of cardiovascular adverse events in HFpEF patients.
| [1] |
METRA M, TEERLINK J R. Heart failure[J]. Lancet, 2017, 390(10106): 1981-1995. doi: 10.1016/S0140-6736(17)31071-1
|
| [2] |
张丽伟. 慢性心力衰竭患者血清尿酸、N末端B型利钠肽原、血管形成抑制素-2与左心室射血分数的相关性[J]. 实用临床医药杂志, 2020, 24(12): 29-31. doi: 10.7619/jcmp.202012008
|
| [3] |
朱小山, 张红申, 杨峰, 等. CHF病人血清儿茶酚抑素、和肽素水平与心力衰竭严重程度及短期心血管事件的关系分析[J]. 中西医结合心脑血管病杂志, 2019, 17(4): 566-569. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201904024.htm
|
| [4] |
PONIKOWSKI P, VOORS A A, ANKER S D, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failureThe Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur Heart J, 2016, 37(27): 2129-2200. doi: 10.1093/eurheartj/ehw128
|
| [5] |
NAIR N. Epidemiology and pathogenesis of heart failure with preserved ejection fraction[J]. Rev Cardiovasc Med, 2020, 21(4): 531-540. doi: 10.31083/j.rcm.2020.04.154
|
| [6] |
GOMES R A F, POMPEU BARROS DE OLIVEIRA SÁM, SOBRAL FILHO D C. Contributions of the heart rate turbulence method to risk stratification in patients after myocardial infarction: a review[J]. Am J Cardiovasc Dis, 2022, 12(1): 19-30.
|
| [7] |
ZUERN C S, BARTHEL P, BAUER A. Heart rate turbulence as risk-predictor after myocardial infarction[J]. Front Physiol, 2011, 2: 99. http://www.socolar.com/Article/Index?aid=100020875721&jid=100000008430
|
| [8] |
PIESKE B, TSCHÖPE C, DE BOER R A, et al. How to diagnose heart failure with preserved ejection fraction: the HFA-PEFF diagnostic algorithm: a consensus recommendation from the Heart Failure Association (HFA) of the European Society of Cardiology (ESC)[J]. Eur Heart J, 2019, 40(40): 3297-3317. doi: 10.1093/eurheartj/ehz641
|
| [9] |
BRAUNISCH M C, MAYER C C, BAUER A, et al. Cardiovascular Mortality Can Be Predicted by Heart Rate Turbulence in Hemodialysis Patients[J]. Front Physiol, 2020, 11(77): 1-11.
|
| [10] |
SCHMIDT G, MALIK M, BARTHEL P, et al. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction[J]. Lancet, 1999, 353(9162): 1390-1396. doi: 10.1016/S0140-6736(98)08428-1
|
| [11] |
LOMBARDI F, STEIN P K. Origin of heart rate variability and turbulence: an appraisal of autonomic modulation of cardiovascular function[J]. Front Physiol, 2011, 2: 95.
|
| [12] |
YAMADA S, YOSHIHISA A, HIJIOKA N, et al. Autonomic dysfunction in cardiac amyloidosis assessed by heart rate variability and heart rate turbulence[J]. Ann Noninvasive Electrocardiol, 2020, 25(4): e12749.
|
| [13] |
YAMADA S, YOSHIHISA A, SATO Y, et al. Utility of heart rate turbulence and T-wave alternans to assess risk for readmission and cardiac death in hospitalized heart failure patients[J]. J Cardiovasc Electrophysiol, 2018, 29(9): 1257-1264.
|
| [14] |
AL-ZAITI S S, PIETRASIK G, CAREY M G, et al. The role of heart rate variability, heart rate turbulence, and deceleration capacity in predicting cause-specific mortality in chronic heart failure[J]. J Electrocardiol, 2019, 52: 70-74.
|
| [15] |
UPADHYA B, KITZMAN D W. Heart failure with preserved ejection fraction: new approaches to diagnosis and management[J]. Clin Cardiol, 2020, 43(2): 145-155.
|
| [16] |
BOROVAC J A, D'AMARIO D, BOZIC J, et al. Sympathetic nervous system activation and heart failure: current state of evidence and the pathophysiology in the light of novel biomarkers[J]. World J Cardiol, 2020, 12(8): 373-408.
|
| [17] |
D'AMARIO D, MIGLIARO S, BOROVAC J A, et al. Microvascular dysfunction in heart failure with preserved ejection fraction[J]. Front Physiol, 2019, 10: 1347.
|
| [18] |
张宜春, 徐岩, 辜和平. 米力农对老年难治性心力衰竭患者心率震荡的影响[J]. 实用临床医药杂志, 2010, 14(23): 48-49. doi: 10.3969/j.issn.1672-2353.2010.23.021
|
| [19] |
ZHAO Y N, DENG H H, YANG P. Clinical significance of heart rate turbulence in prognosis assessment of patients with chronic heart failure[J]. Journal of Jilin university (medicine Edition), 2015, 41(2): 374-378.
|
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