Clinical Significance Of Heart Rate Turbulence In Patients With Chronic Heart Failure

Research Background: Due to the high rate of sudden death in patients withchronic heart failure, identify high-risk patients is very important.Heart rateturbulence（HRT），including turbulence onset(TO) and turbulence slope(TS), Is apowerful predictor of mortality in patients with chronic heart failure.The aim of thisstudy is to investigate clinical significative of heart rate turbulence with chronicheart failure(CHF)；the relationship of HRT and cardiac fuction grading，to study thecorrelation of heart rate turbulence and traditionary index：left ventricular ejectionfraction、Left ventricular end-diastolic diameter、brain natriuretic peptide；analyzedthe relationship of HRT changes and prognosis of patients（within3months）.Expounded the significance of the change of HRT in patients with heart failure.Research Methodology: The study selected patients with congestive heartfailure treated in our hospital between March,2012and November,2012as researchobjects. According to the inclusion and exclusion criteria,50cases were selected,including30cases of ischemic cardiomyopathy,10cases of dilated cardiomyopathy，6cases of valvular disease and4cases of Pulmonary heart disease. According toNYHA classification of heart function, these patients can be divided into19cases ofNYHAⅡ,17cases of NYHA Ⅲ and14cases of NYHA Ⅳ. There are27male patientsand23female patients aged24-87with an average age of64.68±13.88岁. While25cases coming to our hospital for health checkup during the same period wereselected as control group. The records of patients include sex, age, height, bodyweight, Determination of serum brain natriuretic peptide levels within24hours afteradmission in patients with heart failure，left ventricular ejection fraction(LVEF)andleft ventricular end diastolic diameter (LVEDD) of all the75subjects were measured by echocardiography. Then turbulence onset(TO) and turbulence slope(TS) were obtained from Holter analysis. The values of TO、TS、BNP、LVEF、LVEDD were compared between heart failure group and control group, and betweenpatients with different cardiac function grading. And the major cardiovascularevents、mortality and repeated episodes of hospitalization for heart failure symptomsafter discharge were recorded within3months by telephone follow-up and queries.Research Results: HRT of the CHF patients was significantly weakened,The TOand LVEDD of the CHF patients were significantly increased than those of thecontrol group,with the TS and LVEF significantly reduced（P＜0.05or＜0.01）。The TO、LVEDD、BNP of the moderate-to-severe group were slightly higher thanthose of the mild group, the TS and LVEF of the moderate-to-severe group weresignificantly reduced than those in the mild group(P＜0.05or＜0.01)。The TS andLVEF of the mortality group were significantly reduced than those in survivedgroup,and the TO、BNP were significantly increased（P＜0.05）. The TS and LVEFof good prognosis group were significantly increased than those in poor prognosisgroup, and the TO、BNP were significantly induced（P＜0.05）. Most cases werefrom mild group in HRT0(P＜0.05)，more patients with moderate-to-severe CHFgroup than mild CHF group,but with no statistical significance,HRT2:patients frommild CHF group were significantly less than moderate-to-severe CHF group(P＜0.05). TO correlated with BNP and LVEDD（P＜0.05）and reversely correlated withLVEF（P＜0.05）,TS correlated with LVEF（P＜0.05）and reversely correlated withBNP（P＜0.05）.Research conclusions: HRT is a valuable ECG indicators. HRT reflects thebaroceptor sensitivity and autonomic nervous system function,which has prognosticsignificance in CHF patients.