心率变化与心力衰竭不同发展阶段的关系

Heart rate variation and development of heart failure

摘要:

目的 研究运动前后心率变化与心力衰竭（HF）不同发展阶段的关系。方法 根据ACC/AHA心衰分期标准，选择正常对照组70例、HF高危因素组70例、心功能代偿组70例、HF组32例。以6min步行作为运动负荷，记录受试者运动前后心率的变化，并测量步行距离。比较HF不同发展阶段受试者心率的变化及步行距离，分析心率与6min步行距离的关系。结果 心功能代偿组及HF组静息心率高于正常对照组及HF高危因素组（P＜0.05）。运动后即刻心率4组组间差异无统计学意义（P＞0.05）。心率变化幅度随HF的不同发展阶段呈递减趋势（P＜0.05）。 6min步行距离随HF的不同发展阶段呈递减趋势（P＜0.05）。静息心率与6min步行距离呈负相关（r＝-0.311，P＜0.01），心率变化幅度与6min步行距离呈正相关（r＝0.386，P＜0.01）。结论 静息心率的增快、运动后心率变化幅度的降低及6min步行距离的缩短既可作为判断心功能进入代偿期的评估指标，也可作为HF进展的评估指标。

Abstract:

Objective To study the role of heart rate(HR) variation in predicting the development of heart failure(HF). Methods According to the standard of HF staging system from the American Cardiology College (ACC)/the American Heart Association (AHA), four groups of the subjects were involved in the study: the normal control group (70 cases), HF high risk group(70 cases), cardiac function compensatory group(70 cases) and HF group (32 cases). All subjects underwent the 6-minute walk test. HR before and after the exercise was compared, and the walking distance was recorded. The HR variation and the 6-minute walk distance were compared between different groups. The relationship of HR with the 6-minute walk distance was analyzed. Results The resting HR was higher in cardiac function compensatory group and HF group than in normal control group and HF high risk group (P＜0.05). HR immediately after exercise had no statistical difference between the four groups (P＞0.05). The HR variation degree and 6-min walk distance displayed decreasing tendencies with the gradual development of HF (P＜0.05). The resting HR and the 6-minute walk distance was negatively correlated (r＝-0.311, P＜0.01). HR variation degree and the 6-minute walk distance was positively correlated (r＝0.386, P＜0.01). Conclusions The increase of the resting HR, the reduction of the HR variation degree after exercise and the decrease of the 6-minute walk distance could be used to predict the cardiac function compensatory period and development of HF.