未经证实:心脏交感神经系统(SNS)可能在致心律失常性心肌病(ACM)的心律失常发生中起重要作用。本研究旨在通过心率变异性(HRV)评估ACM患者的心脏SNS活性,并探讨其对持续性室性心动过速(sVT)的预测价值。
UNASSIGNED:共纳入88名ACM患者和65名性别和年龄匹配的健康参与者。时域测量用于评估心脏SNS的活性。有48名ACM患者的独立队列作为验证队列。
UNASSIGNED:ACM患者的所有NN间隔(SDNN)的标准偏差水平较低[118.0(90.3,136.8)与152.0(132.5,174.5)ms,p<0.001]与健康参与者相比。进一步分析显示,有sVT的ACM患者的SDNN水平低于无sVT的患者(105.0±28.1vs.131.8±33.1ms,p<0.001)。多因素logistic回归分析显示SDNN与ACM患者sVT独立相关[比值比(OR)0.59,95%置信区间(CI)(0.45-0.78),p<0.001]。受试者工作特征曲线显示SDNN在预测ACM患者sVT方面具有临床价值[曲线下面积(AUC)=0.73,95%CI(0.63-0.84),p<0.001],这在验证队列中得到了验证。
未经证实:本研究提示ACM患者的HRV受损,SDNN水平在ACM患者sVT的危险分层中具有中等价值。此外,这一发现可能为中西医结合的ACM的进一步管理提供新的目标。
UNASSIGNED: Cardiac sympathetic nerve system (SNS) might play an important role in arrhythmogenesis of arrhythmogenic cardiomyopathy (ACM). This study aims to assess the activity of cardiac SNS in ACM patients by heart rate variability (HRV), and to investigate its predictive value for sustained ventricular tachycardia (sVT).
UNASSIGNED: A total of 88 ACM patients and 65 sex- and age- matched healthy participants were enrolled. The time domain measures were used to evaluate the activity of cardiac SNS. An independent cohort with 48 ACM patients was as the validation cohort.
UNASSIGNED: ACM patients had lower levels of standard deviation of all NN intervals (SDNN) [118.0 (90.3, 136.8) vs. 152.0 (132.5, 174.5) ms, p < 0.001] compared with healthy participants. Further analysis showed ACM patients with sVT had lower levels of SDNN than those without sVT (105.0 ± 28.1 vs. 131.8 ± 33.1 ms, p < 0.001). Multivariate logistic regression analysis showed SDNN was independently associated with sVT in ACM patients [odds ratio (OR) 0.59, 95% confidence interval (CI) (0.45-0.78), p < 0.001]. Receiver operating characteristics curve demonstrated SDNN had clinical values in predicting sVT in ACM patients [area under the curve (AUC) = 0.73, 95% CI (0.63-0.84), p < 0.001], which was verified in the validation cohort.
UNASSIGNED: The present study suggests that HRV is impaired in patients with ACM, and the SDNN level has a moderate value in risk stratification for sVT in ACM patients. In addition, the finding might provide new target for the further management of ACM with integrated traditional Chinese and western medicine.