摘要
Abstract
Objective:To analyze the characteristics of heart rate variability(HRV)and rate-pressure product(RPP)in patients with coronary heart disease complicated with chronic heart failure and their relationship with disease severity.Method:A total of 277 patients with coronary heart disease who were diagnosed and hospitalized at Suqian Hospital,Nanjing Drum Tower Hospital Group between May 2021 and August 2024 were retrospectively enrolled.According to whether chronic heart failure was present,the patients were divided into the combined heart failure group(n=185)and the coronary heart disease group(n=92).In the combined heart failure group,patients were further classified into grade Ⅰ+Ⅱ,grade Ⅲ,and grade Ⅳ subgroups based on NYHA cardiac function grading.HRV and RPP were compared among groups,and their correlations with disease severity were analyzed.Result:Compared with the coronary heart disease group,the standard deviation of the average normal-to-normal intervals(SDANN),the root mean square of successive differences(RMSSD),the percentage of adjacent RR intervals differing by more than 50 ms out of the total number of heartbeats(PNN50),the mean of the standard deviations of all normal-to-normal intervals for all 5-min segments(SDNN Index),high-frequency power(HF),low-frequency power(LF),and very-low-frequency power(VLF)were lower in the combined heart failure group,while the RPP was higher(P<0.05).Multivariate logistic regression analysis shows that,SDANN[OR=0.985,95%CI(0.974,0.996)]and RMSSD[OR=0.790,95%CI(0.708,0.881)]were protective factors for coronary heart disease complicated with chronic heart failure(P<0.05),whereas RPP[OR=1.001,95%CI(1.000,1.001)]was an independent risk factor(P<0.05).Spearman correlation analysis showed that PNN50 and RMSSD were negatively correlated with disease severity(rs=-0.837,-0.647,P=0.000),while the RPP was positively correlated with disease severity(rs=0.666,P=0.000).Conclusion:Reduced HRV and elevated RPP are closely associated with disease severity in patients with coronary heart disease complicated with chronic heart failure,and may serve as effective reference indicators for evaluating disease progression.关键词
冠心病/慢性心力衰竭/心率变异性/心率-压力乘积/相关性Key words
Coronary heart disease/Chronic heart failure/Heart rate variability/Rate-pressure product/Correlation
