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目的探讨缺血性心肌病(ICM)患者的动态心电图特征及其心源性死亡的危险因素。方法回顾性分析68例ICM住院患者的临床资料和动态心电图结果。结果①动态心电图显示:可见各种类型心律失常,以室性心律失常最常见(94.1%);ST-T呈广泛持续性改变(93.7%);心率变异性(HRV)降低的发生率高(90.7%);②心源性死亡与HRV中-重度降低密切相关(t=3.344,p<0.002),且后者与左室射血分数(LVEF)显著下降呈正相关(r=0.69,p<0.05),心源性死亡与室性心律失常程度(x2=0.0007,p>0.05)和房颤(x2=0.06,p>0.05)无关。结论 HRV中-重度降低结合LVEF显著下降可做为ICM患者心源性死亡的预警指标。
Objective To investigate the characteristics of ambulatory electrocardiogram (ECG) and the risk factors of cardiac death in patients with ischemic cardiomyopathy (ICM). Methods The clinical data and ambulatory electrocardiogram of 68 ICM patients were retrospectively analyzed. Results ①Electrocardiogram showed that all kinds of arrhythmia were observed, the most common ventricular arrhythmia was 94.1%, ST-T was extensively changed (93.7%), and heart rate variability (HRV) was decreased 90.7%); ② Cardiac death was closely related to moderate-severe reduction of HRV (t = 3.344, p <0.002), and the latter was positively correlated with a significant decrease of left ventricular ejection fraction (LVEF) 0.05). Cardiac death was not related to the degree of ventricular arrhythmia (x2 = 0.0007, p> 0.05) and atrial fibrillation (x2 = 0.06, p> 0.05). Conclusions The significant decrease of moderate-severe HRV combined with LVEF may be an early warning index for cardiac death in ICM patients.