The influence of deceleration capacity of heart rate and heart rate deceleration runs on evaluating short-term prognosis of 115 patients with acute myocardial infarction / 重庆医学

ABSTRACT

Objective To investigate the effects of altered deceleration capacity of heart rate (DC) and heart rate deceleration runs(DRs) on the short-term prognosis of patients with acute myocardial infarction (AMI) .Methods 115 patients confirmed with AMI within 7 days as AMI group ,50 persons without MI were selected as control group .The deceleration capacity of heart rate and heart rate deceleration runs were detected by the 24 hours Holter within 7 to 14 after onset of AMI ,all the patients were divided in-to high risk group ,medium risk group and low risk group through the Holter results .Left ventricular ejection fraction (LVEF) was evaluated by echocardiography .Compare the risk of the AMI group with the control group .Meanwhile the AMI patients were fol-lowed up for mean(9 .2 ± 1 .7)months .Observe the presence of major adverse cardiovascular events (MACE) .All AMI patients were classified into MACE and non-MACE groups according to the presence of MACE .Analysis the risk factors of MACE .Results AMI group had a significant increase risk but decrease in deceleration capacity of heart rate (P<0 .05) as compared with the control group .In MACE group ,the rate of high risk was significant increasing(P=0 .005) ,but the rate of low risk was significant decrea-sing(P=0 .039) .The Logistic regression analysis showed that LVEF ,high risk group ,age and percutaneous transluminal coronary intervention(PCI) were independent risk factors on presence of MACE .Correlation r was 0 .33 ,0 .30 ,0 .23 ,0 .18 respectively ,and odds ratio was 4 .83 ,4 .28 ,2 .22 ,1 .58 respectively ,the correlation with deceleration capacity of heart rate was a little weaker than LVEF .The coefficient of determination r2 was 0 .528 when the LVEF and ages went into regression ,whereas that was 0 .635 when the LVEF ,high risk group and age went into regression together .Conclusion Capacity of heart rate decelerate was significantly weakened in AMI patients .LVEF ,the significantly decreased deceleration capacity of heart rate ,age and PCI were independent risk factors on presence of short-term MACE in AMI patients .The prognostic value of the DC and DRs was a little weaker than the LVEF .The better predictive value was obtained if the LVEF ,the significantly decreased deceleration capacity of heart rate ,age were combined .