目的:本研究旨在回顾性评估LQTS患儿的心脏自主神经活动,考虑到基因型,症状,性别,年龄,和β受体阻滞剂治疗(BB),并将其与健康对照进行比较。
方法:心率变异性(HRV),使用功率谱分析,在116名LQTS儿童和69名健康儿童的575份动态心电图记录中进行了分析。数据分为四个年龄组和四个心率(HR)范围。
结果:在LQT1和LQT2中,与对照组相比,增加的HR对应于显着降低的低频(LF)和高频(HF)。在HR120-140bpm时,所有LQT1年龄组的总功率(PTOT)均低于对照组(1-15岁:p<.01;15-18岁:p=.03)。在HR80-100时,1-10岁的LQT1患者的HF低于LQT2患者(1-5年:p=0.05;5-10年:p=0.02),15-18岁的LQT2患者的HF低于LQT1患者(p<0.01)。10-15岁有症状的患者在HR100-120bpm时的PTOT低于无症状患者(p=.04)。10-15岁和15-18岁的LQT1女孩的PTOT较男孩低(10-15岁:p=.04;15-18岁:p=.02)。
结论:本研究显示了HR与HRV参数变化之间的相关性。在较高的HR下,LQTS患者的HRV值通常低于对照组,表明有异常的自主反应.这些结果可能会加强LQTS中体力活动与心律失常之间的联系。
OBJECTIVE: This study aimed to retrospectively assess cardiac autonomic activity in children with LQTS, considering genotype, symptoms, sex, age, and beta-blocker therapy (BB) and compare it to healthy controls.
METHODS: Heart rate variability (HRV), using power spectrum analysis, was analyzed in 575 Holter recordings from 116 children with LQTS and in 69 healthy children. The data were categorized into four age-groups and four heart rate (HR) ranges.
RESULTS: In LQT1 and LQT2, increasing HR corresponded to significantly lower low (LF) and high frequency (HF) compared to controls. Total power (PTOT) was lower in all LQT1 age-groups compared to controls at HR 120-140 bpm (1-15 years: p < .01; 15-18 years: p = .03). At HR 80-100, LQT1 patients aged 1-10 years had lower HF than LQT2 patients (1-5 years: p = .05; 5-10 years: p = .02), and LQT2 patients aged 15-18 years had lower HF than LQT1 patients (p < .01). Symptomatic patients aged 10-15 years had lower PTOT at HR 100-120 bpm than asymptomatic patients (p = .04). LQT1 girls aged 10-15 and 15-18 years had a lower PTOT (10-15 years: p = .04; 15-18 years: p = .02) than boys.
CONCLUSIONS: This study shows a correlation between HR and changes in HRV parameters. At higher HRs, LQTS patients generally had lower HRV values than controls, suggesting an abnormal autonomic response. These results may strengthen the link between physical activity and arrhythmias in LQTS.