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| Evaluation value of heart rate variability and arrhythmia on prognosis of patients with acute pulmonary embolism |
| WAN Jianping, YANG Weiluo, YANG Xuli, YANG Zefu, SONG Shibo |
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Abstract Objective To explore the clinical value of heart rate variability (HRV) and the incidence of arrhythmia on the risk stratification and prognostic evaluation of acute pulmonary embolism (APE). Methods The clinical data of 100 APE patients admitted to our hospital were retrospectively analyzed. All of them had been diagnosed by imaging examination. According to the clinical manifestations, simplified pulmonary embolism severity index, right ventricular dysfunction and levels of myocardial injury markers, the enrolled patients were divided into high risk group (33 cases), medium risk group (41 cases), and low risk group (26 cases). Within 24 hours after being diagnosed, patients of each group underwent 24-hour ambulatory electrocardiography examination, with HRV indexes including SDNN, SDANN and ASDNN, the incidence of arrhythmias, and the detection rate of various types of arrhythmias recorded. Meanwhile, the levels of NT-proBNP and D-dimer were tested, and made univariate regression analysis along with HRV indexes and the incidence of arrhythmias, so as to clarify the independent variables affecting the risk stratification of APE. Results The incidence of arrhythmia in highrisk group is significantly higher than that in medium and low risk group (P<0.05) while the incidence of arrhythmia in mediumrisk group is significantly higher than that in lowrisk group (P<0.05). The HRV indexes of SDNN, SDANN and ASDNN in high risk group are significantly lower than those in medium and low risk group with statistically significant differences (P<0.05). The levels of NT-proBNP and D-dimer in high risk group are significantly higher than those in medium and low risk group (P<0.05). The orderly multi-classified Logistic regression analysis shows that ventricular arrhythmia, atrioventricular and bundle branch block, SDNN, and NT-proBNP and D-dimer level are independent risk factors for the risk stratification of APE (P<0.05). Conclusion HRV indexes and the incidence of arrhythmia can be used as important reference indicators for making risk evaluation of APE, and the former can be applied in the prognostic evaluation of APE patients.
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