Characteristics Of Heart Rate Variability In Patients With Coronary Heart Disease Complicated With Chronic Heart Failure And Its Correlation With Disease Severity

Objective:To investigate the characteristics of heart rate variability(HRV)in patients with coronary heart disease complicated with chronic heart failure(CHF)and the correlation between disease severity and HRV.Methods:A total of 232 CHD patients hospitalized in the department of Cardiology of our hospital from November 2020 to June 2021 were selected.According to whether there was chronic heart failure,they were divided into CHD with chronic heart failure group(n = 126)and CHD group(n = 106).At the same time,88 hospitalized patients with coronary artery disease excluded by coronary angiography or coronary CT were selected as the control group.Gender,age,body mass index(BMI),history of diabetes,number of cases using beta-blockers,history of smoking,alcohol consumption,hypertension and other medical records were collected.hs-c Tn I,N-terminal B-type natriuretic peptide progen(NT-pro BNP),myoglobin(Myo),creatine kinase isoenzyme MB(CK-MB),total cholesterol(TCHO),hemoglobin(HGB),triglyceride(TG)and other biochemical indicators,Left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF),left ventricular contraction fraction(FS),end systolic volume(ESV),stroke volume per minute(SV),end diastolic volume(EDV)and other cardiac ultrasound indicators and 24 H Dynamic electrocardiogram was used to measure HRV time domain analysis indicators(SDNN,r MSSD,PNN50,TRI).SPSS23.0 statistical software was used to analyze the differences of above indicators between the control group and the CHD group and the CHD combined with chronic heart failure group.Multivariate binary Logisitic regression model was used to analyze the independent influencing factors of CHD,CHF,and CHD with CHF.The CHD with CHF group was divided into class Ⅱ,Class Ⅲ,and class Ⅳ according to the New York Heart Association(NYHA)heart function classification.Spearman rank correlation was used to analyze the correlation between disease severity and heart rate variability(HRV).Results:1.Comparison of SDNN,r MSSD,PNN50,TRI and maximum heart rate between control group,CHD group and CHD combined with chronic heart failure group showed statistical significance(P<0.05);Compared with the control group,SDNN,r MSSD,PNN50,TRI and maximum heart rate were statistically significant in CHD group and CHD with heart failure group(P<0.05);Compared with CHD group,THE SDNN,r MSSD,PNN50 and TRI of CHD combined with heart failure group were statistically significant(P<0.05);2.Control group,coronary heart disease group,coronary heart disease with chronic heart failure group,three groups compared LAD,LVEDd,LVEF,FS,ESV,EDV,hs-c Tn I,NT-prob NP,Myo,CK-MB,HGB,CHO,TG,further pin-pide comparison found:Compared with the control group,NT-pro BNP in CHD group was statistically significant(P<0.05),LAD,LVEDd,ESV,EDV,Myo,NT-prob NP,LVEF,FS,TCHO in CHD combined with heart failure group had statistical significance(P<0.05),compared with CHD group,THE LVEF,FS,HGB,TG,LAD,LVEDd,ESV,EDV,hs-c Tn I,NT-prob NP,Myo,CK-MB in CHD group had statistical significance(P<0.05).3.Multivariate Logistic regression analysis shows that: TRI and maximum heart rate were independent correlation factors of CHD,r MSSD,PNN50,maximum heart rate,LAD and FS were independent correlation factors of CHD with chronic heart failure,r MSSD,LVEF,LAD,hs-c Tn I and HGB were independent correlation factors of CHD with chronic heart failure.4.There was a correlation between heart function grading and HRV,and there was a negative correlation between heart function grading and SDNN,r MSSD,PNN50,TRI,and the difference was statistically significant(P<0.05).There was a positive correlation between cardiac function grading and NT-prob NP,and the difference was statistically significant(P<0.05).Conclusion:The heart rate variability of patients with CHD and CHD combined with chronic heart failure is lower than that of normal people,and CHD combined with chronic heart failure can further reduce the heart rate variability of CHD patients,resulting in cardiac autonomic nerve function damage,and the severity of the disease is negatively correlated with HRV.