摘要
目的探讨动态心电图监测心率变异性(HRV)参数及房性期前收缩(PAC)与老年急性心肌梗死(AMI)患者新发心房颤动(NOAF)的相关性。方法选取2019年10月至2021年10月尤溪县总医院收治的老年AMI患者274例,根据住院期间是否发生房颤分为NOAF组(n=23)和非NOAF组(n=251)。比较两组临床特征及HRV参数和PAC情况。采用logistic回归分析AMI患者发生NOAF的影响因素,受试者工作特征(ROC)曲线分析HRV参数、PAC对AMI患者发生NOAF的预测价值。结果NOAF组SDANN、SDNNI、rMSSD、PNN50低于非NOAF组,左心房直径、LVEF≤40%占比、LF/HF及PAC高于非NOAF组(P<0.05)。logistic回归分析显示,SDANN、SDNNI、rMSSD、PNN50降低及左心房直径、LVEF≤40%占比、LF/HF、PAC频次升高均为AMI患者发生NOAF的独立危险因素。ROC曲线显示,HRV参数和PAC联合预测AMI患者发生NOAF的曲线下面积最大(0.944),敏感度和特异度分别为82.61%和94.42%。结论老年AMI患者HRV参数及较高的PAC频率与NOAF密切相关,可作为NOAF早期预测指标。
Objective To investigate the correlation of heart rate variability(HRV)parameters and atrial premature contraction(PAC)monitored by Holter monitoring and new-onset atrial fibrillation(NOAF)in elderly patients with acute myocardial infarction(AMI).Methods A total of 274 elderly patients with AMI admitted to Youxi County General Hospital from October 2019 to October 2021 were divided into NOAF group(n=23)and non-NOAF group(n=251)according to whether atrial fibrillation occurred during hospitalization.The clinical characteristics,HRV parameters,and PAC were compared between the two groups.Logistic regression was used to analyze the influencing factors of NOAF in patients with AMI.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of HRV parameters and PAC for NOAF in patients with AMI.Results SDANN,SDNNI,rMSSD and PNN50 in NOAF group were lower than those in non-NOAF group,while left atrial diameter,LVEF≤40%proportion,LF/HF and PAC frequency were higher than those in non-NOAF group(P<0.05).Logistic regression analysis showed that the decrease of SDANN,SDNNI,rMSSD,PNN50,and increased left atrial diameter,proportion of LVEF≤40%,LF/HF and PAC frequency were all independent risk factors for NOAF in AMI patients(P<0.05).The ROC curve showed that the combined HRV parameters and PAC predicted NOAF in AMI patients had the largest area under the curve(0.944),and the sensitivity and specificity were 82.61%and 94.42%,respectively.Conclusion HRV parameters and higher PAC frequency in elderly patients with AMI are closely related to NOAF and can be used as early predictors of NOAF.
作者
罗丽容
Luo Lirong(Department of ECG,Youxi County General Hospital,Sanming City,Fujian Province,365100,China)
出处
《现代电生理学杂志》
2024年第3期138-142,共5页
Journal of Modern Electrophysiology
关键词
心电描记术
心率变异性
房性期前收缩
急性心肌梗死
心房颤动
Electrocardiography
Heart rate variability
Premature atrial contraction
Acute myocardial infarction
Atrial fibrillation
