| Objective To assess the deceleration capacity of heart rate(DC)and the heart rate deceleration runs(DRs)for the severity and prognosis in patients with chronic heart failure.Methods A total of ninety-two patients with CHF in the First people’s hospital of Hefei from August 2017 to June 2018 were erolled as the CHF group,and the same period of gender,age matched sixty-six healthy cases served as the control group.Collecting the basic information of the two groups,and,according to the NewYork Heart Association classification,CHF patients were divided into the level II(28 cases),level III(36 cases)and level IV(28 cases).Based on the 24-hour dynamic electrocar-diogram and the echocardiogram,the levels of DC,DRs and average heart rate parameter were compared between the CHF group and control group,the DC,DRs,LVEDD and LVEF were compared between the CHF subgroups.All patients were followed up for 6~12 months.The cardiac death,cardiogenic shock,malignant arrhythmia and rehosp-italization due to heart failure were further analyzed according to the different DC and DRs values in the CHF patients(low,medium and high risk groups).Results(1)There were no significant differences between the CHF group and the control group in baseline characteristics,including age,gender,history of hypertension,diabetes,renal function and blood lipid.(all P>0.05).Compared with the control group,the left ventricular end-diastolic volume of the heart failure group increased significantly,and the left ventricular ejection fraction decreased,the differences were statistically significant(P<0.01).(2)DC,DRs and HRV value had decreased significantly and average heart rate increased in the CHF group compared to the control group(P<0.05).(3)With the decrease of cardiac function,the value of DC,DRs and LVEF decreased gradually and the value of LVEDD increased gradually,,and here is statistical difference among the DC,DR4,DR8,LVEDD and LVEF.(4)The group of patients with cardiac adverse events during the follow-up period showed that DC,DRs and HRV in the event group were significantly lower than those in the nonevent group(P<0.05).(5)Compared with the low-medium risk group,the incidence of cardiovascular event due to heart failure were significantly higher in the high-risk group(P<0.05).(6)Compared with the low-medium risk group found that the incidence of cardiovascular events was significantly higher in the high-risk group(P<0.05),suggesting that patients in the high-risk stratification had a poor prognosis.(7)Correlation analysis between DC and DRs values of the study subjects and HRV time domain indicators and LVEDD and LVEF indicated that DC,DR2,DR4 and DR8 were positively correlated with SDNN,SDANN,SDNN Index and LVEF,and DC and rMSSD were positive,correlation was negatively correlated with LVEDD and HR,and the correlation between the indicators was statistically significant.Conclusions DC and DRs of patients with CHF were significantly decreased,suggesting that their vagus nerve function was impaired and the protective effect of the vagus nerve on the cardiovascular system was reduced.DC and DRs values can effectively reflect the vagus nerve function status and significantly assess the risk and prognosis of CHF.They can guide doctors to timely treat patients with heart failure,improve survival therapy and improve patients’ long-term prognosis. |
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