Abstract：Objective To investigate the relationship between risk stratification of heart rate deceleration runs(DRs) and deceleration capacity(DC), standard diviation of NN intervals(SDNN), left ventricular ejection fraction(LVEF) as well as severity of coronary artery stenosis in patients with acute myocardial infarction(AMI). MethodsThirtyeight cases with AMI and 20 healthy subjects underwent 24hour ambulatory electrocardiography and echocardiogram examinations while their DC values, DRs, HRV time domain indexes of SDNN and LVEF were measured. Coronary angiography was carried out on AMI patients to record the degree of coronary artery stenosis. According to the results of DRs, all of the enrolled subjects were divided into lowrisk group(17 cases), mediumrisk group(15 cases), highrisk group(6 cases) and control group(20 cases). Amongst the 4 groups, ages, DC values, SDNN, LVEF and degree of coronary artery stenosis were compared. Results① Compared with lowrisk group, there was a significant rise of ages in highrisk group with statistically significant difference(P<0.05). ② From control group to highrisk group, values of DC and SDNN decreased gradually. The two indexes significantly reduced in highrisk group if compared with the other 3 groups, with statistically significant difference(P<0.05). ③ There was no obvious correlation between risk stratification of DRs and degree of coronary artery stenosis. ConclusionFor AMI patients, the risk stratification of DRs and DC, SDNN are significantly correlated, all of which can evaluate vagus tension of AMI patients and a combination of which can improve early warning of sudden death after myocardial infarction.
[1] 郭继鸿.猝死预警新技术：连续心率减速力测定[J].临床心电学杂志，2012，21（3）：227-233.[2] Bauer A，Kantelhardt JW，Barthel P，et al.Deceleration capacity of heart rate as a predictor of mortality after myocardial infarction:cohort study[J].Lancet，2006，367(9523):1674-1681.[3] 胡亚红，崔俊玉，王斌，等.急性心肌梗死患者心率减速力检测的研究[J].临床心电学杂志，2010，19（4）：250-251.[4] Lewek J，Wranicz JK，Guzik P，et al.Clinical and electrocardiographic covariates of deceleration capacity in patients with STsegment elevation myocardial infarction[J].Cardiol J，2009，16(6):528-534.[5] Pan Q，Gong Y，Gong S，et al.Enhancing the deceleration capacity index of heart rate by modifiedphaserectified signal averaging[J].Med Biol Eng Comput，2010，48（4）:399-405.[6] 李佐民，邓宇英，杨震.冠心病维持性血液透析患者心率减速力与心率变异性的分析[J].中国心血管病研究，2013， 11（3）:173-175.[7] Bauer A，Barthel P，Schneider R，et al.Improved stratification of autonomic regulation for risk prediction in postinfarction patients with preserved left ventricular function(ISARRisk) [J].Eur Heart J，2009，30(5):576-583.[8] Kleiger RE，Miller JP，Bigger JT，et al.Decreased heart rate variability and its association with increased mortality after acute myocardial infarction[J].Am J Cardiol，1987，59(4):256-262.[9] Guzik P，Piskorski J，Barthel P，et al.Heart rate deceleration runs for postinfarction risk prediction[J].J Electrocardiol，2012，45(1):70-76.
2014, Vol. 23 
