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目的探讨心房颤动患者心率变异性与左心房大小的相关性。方法42例持续性心房颤动患者行24 h动态心电图检查,检测心率变异性时域指标,并进行超声心动图检查,记录左心房、左心室直径、左心室射血分数等参数,再分析以上两者的相关性。结果①心率变异性各指标实测值与超声心动图各参数无关;②以平均心室率矫正后的有关心率变异指标与患者左心房、左心室直径大小呈负相关(P<0.01),其中以RMSSDDd iff(白天NN间期之差的均方根值与预期值之差)相关性最强(P<0.01);③多因素逐步回归分析显示,左心房大小直径是影响心率变异性的独立的指标。结论心房颤动患者的心率受多重影响,在作HRV分析时须以平均心室率矫正;HRV有关指标与左心房、左心室直径大小相关,而左心房直径增大是心率变异性减低的独立影响因子。
Objective To investigate the relationship between heart rate variability and left atrial size in patients with atrial fibrillation. Methods Twenty-four patients with persistent atrial fibrillation underwent 24 h ambulatory electrocardiogram examination. The time-domain index of heart rate variability was measured. Echocardiography was performed to record the left atrium, left ventricular diameter and left ventricular ejection fraction. The relevance of the person. Results ① The measured values of heart rate variability were independent of echocardiographic parameters. ② The heart rate variability index corrected with mean ventricular rate was negatively correlated with left atrium and left ventricular diameter (P <0.01). The RMSSDDd iff (daytime difference between the rms and expected value of the difference) the strongest correlation (P <0.01); ③multivariate stepwise regression analysis showed that the size of the left atrium size is an independent indicator of heart rate variability . Conclusions The heart rate of patients with atrial fibrillation is affected by multiple factors, and the mean ventricular rate should be corrected when HRV analysis is performed. The relevant indicators of HRV are related to the diameter of left atrium and left ventricle. The increase of left atrium diameter is an independent factor of heart rate variability .