| Objective To study the relationship between the variation of heart rate (HR) andthe different stages of heart failure (HF).Methods According to the standard of heart failure staging system from theAmerican College of Cardiology Foundation (ACC)/the American HeartAssociation (AHA), four groups of the subject were involved in the study:90patients of the normal control group,90patients of A stage (high risk factorgroup),90patients of B stage (cardiac functional compensatory group), and32patients of C stage (HF group). Then high risk factor group was divided intothree subgroups of diabetes mellitus (DM), coronary artery disease (CAD) andprimary hypertension,30cases of each subgroup from high risk factor group.Sub-clinical patients including the normal control group, high risk factor group,and cardiac functional compensatory group were again divided into threesubgroups of presenium, senium1and senium2,30cases of each subgroup from the three sub-clinical HF groups. The resting HR, systolic blood pressure (SBP),oxygen saturation (Sa02%) were recorded. Then the6-minute walk was used asan exercise load. HR during and after the exercise were recorded, the walkingdistance (6MWD) was measured, and the norepinephrine (NE) before and afterthe exercise were measured. The results were analysed by t test, one-wayanalysis of variance and pearson linear correlation:①The resting HR, the HRincreasing quantities (△HR6min) and the HR variety (HR-V%6min) at the sixthminute of the exercise, and6MWD of the patients with sub-clinical HF werecompared;②The resting HR,△HR6min, HR-V%6min,6MWD, SBP andrate-pressure product (RPP) of the patients with the different high risk factors ofHF were compared;③The resting HR, HR and the HR increasing quantities atthe first minute and the sixth minute of the exercise, and6MWD of the agesubgroups were compared;④The resting HR,△HR6min, HR-V%6min,6MWD,the resting NE, and NE after the exercise of the patients with the differentprogresses of HF were compared;⑤The relationship of the resting HR and theresting NE, the relationship of the resting HR and6MWD, the relationship of△HR6min, HR-V%6min and6MWD, and the relationship of6MWD and theresting NE were analyzed.Results⑴.①The resting HR of cardiac functional compensatory group weremore than that of high risk factor group and the normal control group (P<0.05);②△HR6min, HR-V%6min and6MWD of cardiac functional compensatory groupwere less than that of high risk factor group and the normal control group(P<0.05).⑵.①The resting HR,△HR6min, HR-V%6min, the SBP increasingquantities and the SBP variety at the sixth minute of the exercise, and6MWD ofthe hypertension subgroup were same with that of CAD subgroup, DM subgroupand the normal control group (P>0.05);②The resting SBP and the resting RPPof the hypertension subgroup were more than that of CAD subgroup, DM subgroup and the normal control group (P<0.05).⑶.①HR and the HR increasing quantities at the first minute of the exerciseof the senium2subgroup from the normal control group and high risk factorgroup were less than that of the presenium subgroup and the senium1subgroup(P<0.05). The resting HR,△HR6min, HR-V%6min and6MWD of the senium2subgroup from the normal control group and high risk factor group were samewith that of the presenium subgroup and the senium1subgroup (P>0.05);②HRand the HR increasing quantities at the first minute of the exercise, HR6min,△HR6min, HR-V%6min and6MWD of the senium2subgroup from cardiacfunctional compensatory group were less than that of the presenium subgroupand the senium1subgroup (P<0.05), the resting HR of the senium2subgroupfrom cardiac functional compensatory group were same with that of thepresenium subgroup and the senium1subgroup (P>0.05).⑷.①The resting HR of high risk factor group, cardiac functionalcompensatory group and HF group increased successively (P<0.05);②△HR6min, HR-V%6min and6MWD of high risk factor group, cardiac functionalcompensatory group and HF group decreased successively (P<0.05);③Theresting NE and NE after the exercise of high risk factor group, cardiac functionalcompensatory group and HF group increased successively (P<0.05);④Therelationship between the resting HR and the resting NE was positive (r=0.209,P<0.05), the relationship between the resting HR and6MWD was negative (r=-0.260, P<0.01), the relationship between△HR6min, HR-V%6min and6MWDwere positive (r=0.251,0.268, P<0.01), the relationship between6MWD andthe resting NE was negative (r=-0.224, P<0.05).Conclusions①The increasing of the resting HR, the reducing of△HR6min andHR-V%6min, and the shortening of6MWD could be used to differentiate thecardiac functional compensatory period and assess the progress of HF.②The related parameters of the heart rate from the patients with hypertension were same with that of the patients with CAD and DM, beforecardiac functional compensatory period.③The related parameters of the heart rate at the first minute of the exerciseis not recommended as the index of assessing the HF progress. |
