Abstract:

Objective To investigate the changes of heart rate turbulence (HRT) in the patients with heart failure,and to clarify its clinical significance in the prognosis assessment of the patients with heart failure.Methods 50 patients with chronic heart failure(CHF) (CHF group) and 25 normal controls (control groups) were selected. The levels of serum brain natriuretic peptide (BNP) within 24 h after admission in CHF patients were detected,and the values of left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter (LVEDD) of all the 75 subjects were measured by echocardiography; the values of turbulence onset(TO) and turbulence slope (TS) were obtained by Holter analysis. The values of TO,TS,LVEF,LVEDD,levels of BNP,and HRT grading were compared between CHF group and control group.And the major cardiovascular events,mortality and repeated episodes of the hospitalization for the heart failure symptoms after discharge were recorded; Logisitic regression analysis was used to analyze the relationship between the death and HRT grading.Results The value of TO and value of LVEDD of the patients in CHF groups were significantly higher than those in control group(P<0.01),and the value of TS and value of LVEF were significantly lower than those in control group(P<0.01).The value of TO,level of BNP,and value of LVEDD of the patients in moderate and severe heart failure group were slightly higher than those in mild heart failure group(P<0.05,P<0.01),and the value of TS and value of LVEF were significantly lower than those in mild heart failure group(P<0.01).The value of TS of the patients with good prognosis was significantly higher than that of the patients with poor prognosis(P<0.05),and the value of TO was significantly lower(P<0.05). There were positive relationship between the value of TO and level of BNP and value of LVEDD(r=0.33,r=0.349,P<0.05) and negative relationship with value of LVEF(r=-0.440,P<0.05).There were positive relationship between the value of TS and value of LVEF(r=0.326,P<0.05)and negative relatiohship with level of BNP(r=-0.403,P<0.05). The value of TO and level of BNP of the patients in mortality group were significantly higher than those in survival group(P<0.05),and the values of TS and LVEF were significantly lower than those in control group(P<0.05).Conclusion HRT significantly is reduced in the CHF patients,and the decreasing of HRT has the prognostic significance in the CHF patients.

Key words: heart rate turbulence, chronic heart failure, risk assessment, prognosis