| Objective: To explore the application of heart rate variability(HRV) in patients with diastolic heart failure(DHF), analyze the relationship between HRV and heart failure(HF), and evaluate the diagnosis value of HRV in DHF.Then, the difference in HRV between DHF patients and systolic heart failure(SHF) patients was measured, and its influence on diagnosis and prognosis investigated.Methods: 156 patients with heart failure in the second hospital of Tianjin Medical University from January 2014 to January 2016 were enrolled in the study,and all of them underwent HRV test. 70 patients were men and the others were women;their ages were 19-80 years old(56.94±13.98). Of this group,88 cases of systolic heart failure and 68 cases of diastolic heart failure were observed. According to NYHA cardiac function grading, there were50 cases in NYHAⅡgroup,50 cases in NYHA Ⅲ group, and 56 cases in NYHA Ⅳ group. 32 normal cases in the control group were compared with the HF group. Of the control group,14 of were men and 18 of them were women, with an average age of 57.22±13.76 years old. The control group has no serious illnesses in the cardiac, respiratory, digestive, and urinary systems. After collecting the age, sex, and history of their illness, biochemical indicators included liver function, HDL-c, LDL-c, ALT, CREA, and NT-pro BNP. HRV indicators in ambulatory electrocardiogram included SDNN, SDANN, SDANN index,RMSSD, PNN50,HF,LF, and LF/HF. Finally, indicators in echocardiogram included internal diameter of inter-ventricular septum, end diastolic diameter of LV thickness of post wall of LV, and diametersof LA, LVEF, E/A,E/E′.Results: 1. Compared with control group, SDNN, SDANN, SDANN index,RMSSD, PNN50,HF, LF were low(P<0.01), but similar in LF/HF,(P>0.05). 2. SDNN, SDANN, SDANN index,RMSSD,PNN50,HF, and LF were different between NYHA Ⅱ, Ⅲ, Ⅳgroup,(P<0.01),but similar in LF/HF,(P>0.05). 3. Compared with SHF group, DHF groups had higher HRV indexs.However, only RMSSD, PNN50, and HF differences were statistically significant(P<0.01). 4. Compared in the DHF group, HRV index of women was lower than that of men in DHF group, but no different in SDNN, SDANN, LFindex and LF/HF(P>0.05), RMSSD, PNN50,SDANN, and HF was much lower in women than in men(P<0.05). 5. Correlation analysis was used to evaluate the relation between HRV and other index. There was a negative correlation between E/E′and PNN50, RMSSD and HF, Correlation coefficient r was-0.483,-0.484,and-0.469. The depth of the inter-ventricular septum had a negative correlation with SDNN and LF, r values were 0.425 and 0.463. There was a positive correlation between depth of post wall and SDANN, r was 0.382.Conclusion: 1. Compared with the control group, HRV in HF group were low, indicating damage to autonomic nervous function. 2. Change in HRV had a positive correlation with NYHA, indicating when NYHA was worse, the values of HRV were lower. 3.Compared to SHF, DHF has higher HRV indexes, only RMSSD, PNN50, and HF differences were statistically significant, indicating the prognosis of DHF is better than that of SHF. 4. In DHF group,Compared with the men, HRV index of women was lower, indicating the prognosis of women is worse than that of men. 5. In DHF group, there was a negative correlation between E/E ′ and PNN50,RMSSD, and HF.This indicates HRV can be used as an index to evaluate cardiac function. |
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