摘要

OBJECTIVES:This study was designed to assess the temporal changes in vagal responses to atrial premature beats before spontaneous onset of atrial fibrillation (AF).
BACKGROUND:Enhanced vagal activity plays a major role in the onset and perpetuation of experimental AF, but the role of vagal activation in the onset of clinical AF episodes is not so well established.
METHODS:We calculated heart rate turbulence after atrial premature impulses occurring 0 to 60 min before the onset of AF ("prior to AF") and compared it with the hourly means of the other hours of the 24-h electrocardiogram recordings ("non-AF hours") in 39 patients with structural heart disease and 29 patients with lone AF. Traditional heart rate variability measurements and approximate entropy (ApEn) were also analyzed.
RESULTS:Turbulence onset (TO) was significantly less negative during the 1 h preceding AF than during the non-AF hours (0.71 +/- 1.76 vs. -0.35 +/- 1.46, p < 0.00001). Less negative TO before AF was observed among both the patients with structural heart disease (1.16 +/- 1.73 vs. 0.07 +/- 1.23; p < 0.0001) and those with lone AF (0.17 +/- 1.67 vs. -0.85 +/- 1.56; p < 0.0001). No significant difference was seen in the turbulence slope between the two periods, and none of the traditional frequency and time domain measurements differentiated between the periods; ApEn was significantly lower before AF than during the non-AF hours (p < 0.01).
CONCLUSIONS:Altered heart rate dynamics, suggesting transient enhancement of vagal outflow after premature atrial excitation, are temporally related to spontaneous onset of clinical AF.

译文

目的: 本研究旨在评估心房颤动 (AF) 自发发作前房性早搏迷走神经反应的时间变化。
背景: 增强的迷走神经活动在实验性 AF 的发生和延续中起着主要作用,但是迷走神经活动在临床 AF 发作中的作用并不是很确定。
方法: 我们计算了在 AF 发作前 0 到 60 分钟 (“AF 之前”) 发生房性早搏冲动后的心率震荡并将其与 39 名结构性心脏病患者和 29 名单独 AF 患者的 24 小时心电图记录 (“非 AF 小时”) 的每小时平均值进行比较。还分析了传统的心率变异性测量和近似熵 (ApEn)。
结果: 在 AF 之前的 1 小时内,湍流开始 (TO) 比在非 AF 时间内 (0.71/-1.76 vs.-0.35/-1.46, p <0.00001)。在两例结构性心脏病患者中,AF 前的阴性较少 (1.16/-1.73 vs.0.07/-1.23; p <0.0001) 和那些单独 AF (0.17/-1.67 vs.-0.85/-1.56; p <0.0001)。两个周期之间的湍流斜率没有显著差异,并且在两个周期之间没有区别的传统频率和时域测量; AF 前的 ApEn 显著低于非 AF 小时 (p & lt; 0.01)。
结论: 心率动力学的改变,表明房性早搏兴奋后迷走神经流出的短暂增强,与临床 AF 的自发性发作暂时相关。

heart rate turbulence

心血管 HRT 临床研究术语
概述  :  

窦性心率震荡(HRT)现象在20世纪初被心脏病学者发现,经过90多年的临床研究,其检测方法逐步规范,最初应用于急性心肌梗死预后的危险分层,现在广泛应用于心脏病患者预后判断和临床研究,成为心血管疾病猝死风险预测中非常重要的无创检测方法之一。大量的临床研究发现,一次室性早搏给随后的窦性心律带来双相涨落式的变化是正常人特征性的窦性心律适应性改变,称为室相性窦性心律不齐。室性早搏后出现HRT现象,表现为窦性心律先加速随后发生窦性心律减速,见于正常人及心肌梗死后猝死的低危患者;另一种是室性早搏后HRT

Turbulence 英 [ˈtɜːbjələns] 美 [ˈtɜːrbjələns]

释义   n. 骚乱,动荡;[流] 湍流;狂暴

例句   With all the turbulence in the housing market, this is no time to play politics with such a critical appointment.

随着房地产市场的动荡,现在不是拿这样一个关键的任命来玩弄政治的时候。


请扫描右侧二维码,免费查看词汇专业知识背景