目的探究行体外循环下主动脉瓣置换术(aortic valve replacement,AVR)患者围术期心率变异性(heart rate variability,HRV)的变化趋势,以及年龄和(或)术后心房颤动(perioperativeatrial fibrillation,POAF)对这种趋势的影响程度。方法回...目的探究行体外循环下主动脉瓣置换术(aortic valve replacement,AVR)患者围术期心率变异性(heart rate variability,HRV)的变化趋势,以及年龄和(或)术后心房颤动(perioperativeatrial fibrillation,POAF)对这种趋势的影响程度。方法回顾性研究2021年1月至2023年1月在解放军北部战区总医院心血管外科行AVR的134例中、重度主动脉瓣疾病患者住院期间的基线资料,根据患者年龄和(或)是否并发POAF将患者分为A组(年龄<60岁、无POAF,49例)、B组(年龄<60岁并发POAF,21例)、C组(年龄≥60岁、无POAF,30例)、D组(年龄≥60岁并发POAF,34例),收集患者术前7 d与术后7 d动态心电图指标。观察患者围术期HRV变化。结果AVR术后7 d窦性心搏RR间期的标准差、24 h记录的所有5 min段中NN间隔的标准偏差的平均值(average of the standard deviations of NN intervals across all 5-minute segments recorded over a 24-hour period,SDNN_(idx))、R波时间间隔的方均根、连续RR间隔相差大于50 ms的百分比明显低于术前7 d,差异有统计学意义[(61.172±17.449)ms vs(804.567±230.518)ms、(20.284±9.432)ms vs(42.933±12.876)ms、(1.307±0.196)ms vs(1.412±0.148)ms,3.00(1.30,7.23)ms vs 5.30(3.00,10.40)ms,P<0.01];D组术后7 d SDNN_(idx)明显低于A组,差异有统计学意义[(42.568±14.749)ms vs(46.467±11.754)ms,P<0.05]。结论AVR术后早期自主神经功能紊乱,年龄≥60岁并伴POAF患者HRV指标显著下降,迷走神经功能受损加剧,两者协同作用加重紊乱。展开更多
Objective: To investigate the correlation between left ventricular ejection fraction (LVEF) and age with changes in anterior descending CT coronary flow reserve fraction (CT-FFR) before and after transcatheter aortic ...Objective: To investigate the correlation between left ventricular ejection fraction (LVEF) and age with changes in anterior descending CT coronary flow reserve fraction (CT-FFR) before and after transcatheter aortic valve implantation (TAVI), based on references and data summaries. Methods: Seventy-eight patients with severe aortic stenosis diagnosed and treated in the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University from March 2019 to October 2022 were selected to detect the CT coronary flow reserve fraction of the anterior descending branches of the patients before and after transcatheter aortic replacement, and according to the pre- and post-surgery CT coronary flow reserve fractions, patients were divided into the variable group (Group I), the large group (Group II), and unchanged group (Group III), to explore the effects of left ventricular ejection fraction and age on each group. Results: Compared to Group III, in Group I, LVEF mainly influenced CT-FFR to become smaller after TAVI and played a positive role;compared to Group III, age mainly influenced CT-FFR to become larger after TAVI and played a negative role. Conclusion: LVEF and age predict changes in anterior descending CT coronary flow reserve fraction after transcatheter aortic implantation.展开更多
文摘目的探究行体外循环下主动脉瓣置换术(aortic valve replacement,AVR)患者围术期心率变异性(heart rate variability,HRV)的变化趋势,以及年龄和(或)术后心房颤动(perioperativeatrial fibrillation,POAF)对这种趋势的影响程度。方法回顾性研究2021年1月至2023年1月在解放军北部战区总医院心血管外科行AVR的134例中、重度主动脉瓣疾病患者住院期间的基线资料,根据患者年龄和(或)是否并发POAF将患者分为A组(年龄<60岁、无POAF,49例)、B组(年龄<60岁并发POAF,21例)、C组(年龄≥60岁、无POAF,30例)、D组(年龄≥60岁并发POAF,34例),收集患者术前7 d与术后7 d动态心电图指标。观察患者围术期HRV变化。结果AVR术后7 d窦性心搏RR间期的标准差、24 h记录的所有5 min段中NN间隔的标准偏差的平均值(average of the standard deviations of NN intervals across all 5-minute segments recorded over a 24-hour period,SDNN_(idx))、R波时间间隔的方均根、连续RR间隔相差大于50 ms的百分比明显低于术前7 d,差异有统计学意义[(61.172±17.449)ms vs(804.567±230.518)ms、(20.284±9.432)ms vs(42.933±12.876)ms、(1.307±0.196)ms vs(1.412±0.148)ms,3.00(1.30,7.23)ms vs 5.30(3.00,10.40)ms,P<0.01];D组术后7 d SDNN_(idx)明显低于A组,差异有统计学意义[(42.568±14.749)ms vs(46.467±11.754)ms,P<0.05]。结论AVR术后早期自主神经功能紊乱,年龄≥60岁并伴POAF患者HRV指标显著下降,迷走神经功能受损加剧,两者协同作用加重紊乱。
文摘Objective: To investigate the correlation between left ventricular ejection fraction (LVEF) and age with changes in anterior descending CT coronary flow reserve fraction (CT-FFR) before and after transcatheter aortic valve implantation (TAVI), based on references and data summaries. Methods: Seventy-eight patients with severe aortic stenosis diagnosed and treated in the Department of Cardiovascular Medicine of the Affiliated Hospital of Qingdao University from March 2019 to October 2022 were selected to detect the CT coronary flow reserve fraction of the anterior descending branches of the patients before and after transcatheter aortic replacement, and according to the pre- and post-surgery CT coronary flow reserve fractions, patients were divided into the variable group (Group I), the large group (Group II), and unchanged group (Group III), to explore the effects of left ventricular ejection fraction and age on each group. Results: Compared to Group III, in Group I, LVEF mainly influenced CT-FFR to become smaller after TAVI and played a positive role;compared to Group III, age mainly influenced CT-FFR to become larger after TAVI and played a negative role. Conclusion: LVEF and age predict changes in anterior descending CT coronary flow reserve fraction after transcatheter aortic implantation.
