Correlation Analysis Of Heart Rate Deceleration,heart Rate Variability And Echocardiographic Indicators In Patients With Hypertrophic Cardiomyopathy

Objective:This study analyzed the correlation between the heart rate deceleration(DC),heart rate acceleration(AC),heart rate variability(HRV),and echocardiograPhic indicators in patients with hypertrophic cardiomyopathy(HCM)by using dynamic electrocardiogram and echocardiogram examinations.According to the left ventricular outflow tract obstruction,two subtypes of obstructive hypertrophic cardiomyopathy(OHCM)and non-obstructive hypertrophic cardiomyopathy(NOHCM)were observed.Then we evaluated the risk of sudden death in two subtypes patients and provided the next step for clinical treatment.Methods:During January 2017 to June 2019,62 Patients with MCH in the outpatient department and hospitalization of the First Affiliated Hospital of Soochow University were enrolled as the main research object.According to the results of echocardiography,it was divided into OHCM group(n=14 cases)and NOHCM group(n=48 cases).At the same time,patients who had no abnormalities in cardiac and coronary angiography during the same period in the hospitalization of the cardiology department were selected as normal subjects(control group,n=59 cases),and the control group was subjected to 24h dynamic electrocardiogram(Holter)and transthoracic echocardiography.The differences and correlations between DC,AC,HRV and echocardiographic indicators between the two groups were analyzed and compared.Chinese version of SPSS23.0 was used as statistical analysis software,in this study we used different methods of measurement,test and correlation analysis,P<0.05 was considered statistically significant.Results:1.Compared with the control group,DC and HRV in the OHCM were significantly decreased(P<0.05),and AC was significantly increased(P<0.05).2.Left atrial diameter,septal thickness,and E/e' were significantly increased in the OHCM group compared with control group(P<0.05).3.DC in HCM patients more than 60 years old were significantly lower than those less than 60 years old,and AC was significantly increased in the patient more than 60 years(P<0.05).4.The DC of female patients was significantly lower than that of male patients,and AC was significantly increased(P<0.05).5.The SDNN,SDNN index,triangle index and VLF of OMCH patients were lower than those of NOHCM patients(P<0.05),but there was no significant difference between DC and AC(P>0.05).6.DC was significantly positively correlated with SDNN and LF,AC was significantly negatively correlated with SDNN and LF(P<0.0001).DC was negatively correlated with E/e',AC was positively correlated with E/e'(P<0.05).The DC was positively correlated with the thickness of the interventricular sePtum,and AC is not related to it.Conclusions:1.The indicators of HCM patients showed that DC decreased and AC increased.This may suggest that the autonomic balance function of HCM Patients is impaired,the vagal nerve tension is weakened,and autonomic nerve excitability is increased.2.Age and gender are the influencing factors of DC levels in HCM patients.3.The degree of injury of autonomic nerve injury,OMCH Patients were more serious than NOMCH patients.but there is no difference between DC and AC.4.DC is positively correlated with HRV,which indicates that DC can also better evaluate autonomic function in HCM patients.And DC has a significant negative correlation with the number of clinical events,which can be used as an indicator of early warning of sudden cardiac death.5.DC was negatively correlated with E/e',which may indicate that the worse the left ventricular diastolic function,the lower the vagal tone.