Correlation Between HRV,TH And NE In Patients With Vasovagal Syncope And Different TCM Constitution

Objective:This topic explored the characteristics of Traditional Chinese Medicine(TCM)constitution and its relationship with heart rate variability(HRV),basal tyrosine hydroxylase(TH),basal norepinephrine(NE),response types in patients with asymptomatic vasovagal syncope(VVS),which provided new ideas for objectifying the VVS TCM constitution differentiation of traditional Chinese medicine.Methods:To collect 102 cases of patients with VVS in our Hospital of Cardiology who met the inclusion criteria from January 2018 to December 2019.All of the patients were categorized by response type and TCM classification.The information of clinical data,HRV,NE and TH of asymptomatic period were collected.SPSS20.0 statistical software was used to analyze the results.Results:1.The distribution of onset age of VVS was different(P<0.01);Most cases occurred between the ages of 20-29,while a large proportion occurred between the ages of 60-69 and 50-59.2.88 cases of patients(86.3%)had specific trigger before syncope,the top three triggers for syncope were standing for long periods of time(15.7%),staying up after insomnia(13.7%)and going to the toilet(11.7%).3.The TCM constitution of 102 patients with VVS was as follows: 21 cases of Qi-deficiency constitution(20.6%)>20 cases of Qi-stagnation constitution(19.6%)>19 cases of Mildly constitution(18.6%)>17 cases of Blood-stasis constitution(16.7%)>11 cases of Phlegm-dampness constitution(10.8%)>5 cases of Yin-deficiency constitution(4.9%)>4 cases of Yang-deficiency constitution(3.9%)>3 cases of damp-heat constitution(2.9%)>2 cases of Special-endowment constitution(2.0%).4.SDNN,SDANN,SDNNi,rMSSD,PNN50,TP and HF in patients with cardioinhibitory syncope were lower than those with vasodepressor syncope and mixed syncope(P<0.01),while LF,LF/HF and NE in patients with cardioinhibitory syncope were higher than those with vasodepressor syncope and mixed syncope(P<0.01).RMSSD in vasodepressor syncope patients were lower than the mixed syncope patients(P<0.05),while there was no statistically significant difference in the rest of HRV between vasodepressor syncope patients and mixed syncope patients(P>0.05).There was no significant difference in TH between different response types in VVS patients(P>0.05).5.SDNN,SDANN,SDNNi,PNN50,TP and HF in patients with Blood-stasis constitution and Qi-deficiency constitution were lower than those with Mildly constitution(P<0.05),while LF/HF and TH in patients with Blood-stasis constitution and Qi-deficiency constitution were higher than those with Mildly constitution(P<0.05);LF and NE in patients with Blood-stasis constitution were higher than those with Mildly constitution(P < 0.05);SDNN,SDANN,SDNNi,rMSSD,PNN50,TP and HF in patients with Blood-stasis constitution were lower than those with Qi-stagnation constitution(P<0.05),while LF,LF/HF and TH in patients with Blood-stasis constitution were higher than those with Qi-stagnation constitution(P<0.05).SDNN,SDANN and TP in patients with Qi-deficiency constitution were lower than those with Qi-stagnation constitution(P<0.05);TP in patients with Phlegm-dampness constitution were higher than those with Blood-stasis constitution(P<0.05).6.TH was negatively correlated with SDNN,SDNNi,rMSSD,PNN50,TP and HF(r=-0.398,r=-0.686,r=-0.305,r=-0.253,r=-0.282,r=-0.466,P<0.05).TH was positively correlated with LF,LF/HF and NE(r=0.463,r=0.467,r=0.629,P<0.01).There is no correlation between TH and SDANN(P>0.05).Conclusion:1.The common TCM constitution of VVS patients are: Qi-deficiency constitution,Qi-stagnation constitution,Mildly constitution,Blood-stasis constitution,Phlegm-dampness constitution.2.Based on the response types of VVS patients,there are no statistically significant differences in the activities of autonomic nerve between vasodepressor syncope patients and mixed syncope patients.while,the activities of autonomic nerve in patients with cardioinhibitory syncope are lower than those with vasodepressor syncope and mixed syncope,and the imbalance between sympathetic nervous and vagus nerve is obvious.3.In the common TCM constitution,the degree of imbalance of sympathetic nervous and vagus nerve from high to low are: Blood-stasis constitution,Qi-deficiency constitution,Phlegm-dampness constitution,Qi-stagnation constitution,Mildly constitution.4.As a new biomarker,TH can be used in the diagnosis of VVS patients with traditional auxiliary examination.