原发性高血压患者心率变异性与Syntax评分评价冠脉病变程度的关系

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Abstract Objective To investigate the relationship between severity of coronary artery disease and heart rate variability (HRV) in patients with primary hypertension. Methods From January 2016 to December 2017, 307 patients who were diagnosed as primary hypertension in Chengdu Second People′s Hospital Affiliated to Zunyi Medical University and underwent coronary angiography (CAG) were enrolled in this study. According to the principle of CAG diagnosis of coronary heart disease (CHD), the samples were divided into non-CHD group (121 cases) and CHD group (186 cases), the general clinical data, the biochemical indexes of serology and the 24 h dynamic electrocardiogram of the two groups were compared. Syntax score system was used to evaluate the severity of coronary artery disease, and the CHD group was divided into severe group (53 cases), moderate group (64 cases) and mild group (69 cases) according to the Syntax score. The differences on HRV of the three groups and the relationship between the severity of coronary artery disease and HRV was analyzed. Results The ratio of male, smoking, high cholesterol history, age and high density lipoprotein cholesterol levels of the non-CHD group were lower than those of the CHD group, the differences were statistically significant (P < 0.05). There were no statisticaly significant differences on body mass index, drinking alcohol, history of hyperuricemia, uric acid, total cholesterol, triglyceride and low density lipoprotein cholesterol between non-LDH group and LDH group (P > 0.05). Multivariate two element Logistic regression analysis showed that smoking, age and hyperlipidemia were related to CHD in patients with primary hypertension, the differences were statistically significant (P < 0.05). When comparing the HRV indexes [standard diviation of NN intervals (SDNN), standard deviation of the mean of all 5 minutes segments of normal RR intervals (SDANN), root mean square successive difference between adjacent normal RR intervals (rMSSD), percent of difference between adjacent normal RR intervals that was longer than or equal to 50 ms (PNN50) and low frequency (LF), high frequency (HF), LF/HF] in each group, the indexes of non-CHD group were significantly higher than those of the other groups (P < 0.05), the indexes of the mild group were significantly higher than those of the moderate group and severe group, and the indexes of the moderate group were significantly higher than those of the severe group, the differences were statistically significant (P < 0.05). The time domain and frequency domain indicators in HRV were negatively correlated with the severity of coronary artery disease in patients with CHD (SDNN: r = -0.52, P = 0.000; SDANN: r = -0.50, P = 0.007; rMSSD: r = -0.41, P = 0.018; PNN50: r = -0.45, P = 0.017; LF: r = -0.67, P = 0.009; HF: r = -0.58, P = 0.021). Conclusion Age, smoking and history of hyperlipidemia are the risk factors of CHD in hypertensive patients. The HRV is negatively correlated with severity of coronary artery disease. HRV index can be used to evaluate the severity of coronary artery disease in patients with hypertension.

Key words： Hypertension Heart rate variability Coronary heart disease Syntax score Correlation

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	LI Ke1
	2 LIU Jianxiong2 LIANG Wei2 LIN Lanlan2 YANG Shijian2 WANG Xin2

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LI Ke1,2 LIU Jianxiong2 LIANG Wei2 LIN Lanlan2 YANG Shijian2 WANG Xin2. Correlation between heart rate variability and the severity of coronary artery disease evaluated by Syntax score in patients with primary hypertension[J]. 中国医药导报, 2018, 15(32): 58-62.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I32/58

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