Turbulence dynamics in patients with chronic heart failure

LIU Yong-hua; LIU Yu-jie

doi:10.3969/j.1674-4055.2013.06.16

Abstract：Objective To investigate the changes of new measuring indexes, turbulence dynamics (TD), for sinus heart rate turbulence (HRT), and measuring indexes, including turbulence onset (TO) and turbulence slope (TS), in the patients with chronic heart failure (CHF), and analyze the correlation between new indexes and traditional indexes and their values in the prediction of CHF.Methods The patients (n=120) were chosen from Tianjin Chest Hospital from Sept. 2011 to Jun. 2013 as CHF group, and other patients (n=30) with non-organic heart disease were chosen as control group. CHF group, according to NYHA grade, was further divided into mild CHF group (grade Ⅰ-Ⅱ,n=72) and mid-severe CHF group (grade Ⅲ-Ⅳ,n=48). All patients were given the examination of radioimmunoassay for detecting BNP level, echocardiogram for detecting LAD, LVEDD and LVEF, and 24-h ambulatory ECG for recording SDNN, mean heart rate, HRVPC and RR interval. The indexes of HRT (including TO, TS and TD) were calculated, and the differences among all groups were compared. The correlation between HRT indexes and age, sex, LAD, LVEDD, LVEF and BNP were analyzed.Results Compared with control group, SDNN was shortened [(95.67±30.22) msvs. (131.65±20.71) ms], TO and TD were higher [TO: (-1.50 ±2.71)%vs.(0.61±1.95)%; TD: (0.012±0.004) mm/RRIvs. (0.063±0.031) mm/RRI], LAD and LVEDD were higher [LAD: (36.11±2.24) mmvs. (47.65±2.13) mm; LVEDD: (43.65±7.33) mmvs. (62.13±8.70) mm], BNP increased significantly [(80.05±32.30) pg/mlvs. (941.00±139.17) pg/ml], and TS and LVEF were lower [TS: (12.13 ±3.67)vs. (6.80±5.33); LVEF: (67.30±5.21)%vs. (38.22±12.75)%] in CHF group. All these changes were more significant as CHF exacerbated. In CHF group, TO was negatively related to TS, LVEF and SDNN (P<0.05), and TS was positively related to SDNN (P<0.05) and negatively related to HRVPC and BNP (P<0.05).Conclusion In the patients with CHF, HRT attenuate is significantly attenuated, TO and TS are influenced by SDNN, and TD is not related to HRVPC, SDNN, LVEF and BNP.