Abstract：ObjectiveTo explore the causes of worsened multifactor heart failure(MHF), and to determine the value of heart rate variability(HRV) and the average heart rate within 24 hours in evaluating MHF in elderly people.MethodsWe selected 123 elderly patients with at least two underlying diseases(including hypertension, coronary heart disease and diabetes) as case group, and they had been admitted in the Hospital of Integrated Traditional Chinese and Western Medicine in Beijing from June 2014 to September 2017 undergoing ambulatory electrocardiography examination. According to NYHA cardiac function classification, case group were further divided into normal heart function group(23 cases), NYHA grade Ⅰ group(19 cases), NYHA grade Ⅱ group(59 cases) and NYHA grade Ⅲ-Ⅳgroup(22 cases). Thirty healthy old people were simultaneously taken as control group. The pathogeny, HRV time domain indexes and the average heart rate within 24 hours were comparatively analyzed among the heart failure patients at different NYHA gradings. ResultsIn the NYHA grade Ⅲ-Ⅳgroup, the incidence rate of old myocardial infarction was higher than that in other case subgroups,with statistically significant difference(P＜0.05）. The HRV indexes of SDNN, SDANN, SDNN Index, rMSSD and pNN50 in case group were lower than those in the control group(P＜0.05) while the average heart rate within 24 hours was higher(P＜0.05). Pairwise comparison was made among normal heart function group, NYHA grade Ⅰ and Ⅱ groups, and it was found that SDNN, SDANN, SDNN Index, rMSSD， pNN50 and the average heart rate within 24 hours did not vary significantly(P>0.05). In the NYHA grade Ⅲ-Ⅳ group, SDNN, SDANN, SDNN Index, rMSSD and pNN50 were lower than those in the normal heart function group(P＜0.05) while the average heart rate within 24 hours was significantly higher(P＜0.05). In the NYHA grade Ⅰ group, the above HRV indexes also decreased and the average heart rate increased if compared with those in the NYHA grade Ⅱ group(P＜0.05). ConclusionOld myocardial infarction worsens MHF in elderly people. HRV and the average heart rate within 24 hours are very useful in evaluating elderly MHF of NYHA grade Ⅲ-Ⅳ.
王雪玲. 老年多病因心衰的病因和心率变异性及平均心率分析[J]. 实用心电学杂志, 2018, 27(3): 185-188.
WANG Xue-Ling. Analysis of pathogeny, heart rate variability and the average heart rate in elderly patients with multifactor heart failure. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2018, 27(3): 185-188.
2018, Vol. 27 
