Clinical significance of heart rate variability decrease in elderly patients with multiple organ disorders / 中国综合临床

ABSTRACT

Objective To explore the clinical significance of the heart rate viability decrease in the elderly patients with multiple organ disorders.Methods Two hundred and fifty-nine elderly patients with multiple organ disorders, with underlying diseases as coronary heart disease, hypertension, diabetes, cerebrovascular disease,chronic obstructive pulmonary disease,chronic bronchitis and malignant tumor were enrolled in this study,a retrospective analysis was made on the dynamic electrocardiogram data of the research objects.According to SDNN,123 cases were assigned into the normal HRV group(SDNN≥100ms); 50 cases were divided into the moderately decreased HRV group(50ms≤SDNN<100ms),and 36 cases were divided into the severely decreased HRV group(SDNN<50ms).The average heart rate within 24 hours,clinical diagnosis,and discharge record of the three groups were analyzed.Results As HRV decreased,SDNN decreased gradually (normal HRV group 116(104~131)ms,moderately decreased HRV group 85(67.5~91)ms,severely decreased HRV group 40(35~48)ms),the average heart rate within 24 hours gradually increased(normal HRV group 67(60~76)times/min,moderately decreased HRV group 78(66~84)times/min,severely decreased HRV group 91(80~112)times/min),the differences among the three groups were statistically different(P<0.05).The differences among the groups in the rates of coronary heart disease,hypertension, diabetes,cerebrovascular diseases,chronic bronchitis and chronic heart failure were not statistically significant(P>0.05).The rate of malignant tumor in severely decreased HRV group was 8.3%,significantly higher than that in normal HRV group(0),the difference was statistically significant(P<0.01).In severely decreased HRV group,the rates of chronic obstructive pulmonary disease(25%),chronic renal failure(30.56%),respiratory failure(25%),uremic cardiomyopathy(13.89%),hypoproteinaemia(41.67%)and anemia(41.67%)were significantly higher than those in normal HRV group(1.63%,0.9%,0.81%,0,6.5%,8.94%)and moderately decreased HRV group(7%,11%,2%,3%,11%,11%),the differences were statistically significant(P<0.05) .In moderately decreased HRV group,the rate of chronic renal failure(11%)was higher than that in normal HRV group(0.9%),the difference was statistically significant(P<0.05).Mortality in severely decreased HRV group(41.66%)was significantly higher than that in normal HRV group(2.44%)and moderately decreased HRV group(8%),the difference among the three groups was statistically significant(P<0.05).Conclusion For elderly patients with multiple organ disorders,along with severely decreased HRV,they face the risks of severe imbalances of automatic nervous system,fast heart rate,serious illness,poor nutrition,high mortality.