Study on the clinical application of 24h dynamic electrocardiogram in middle-aged and elderly patients with heart failure
24h动态心电图在中老年心力衰竭患者临床的应用研究

摘要

目的 探讨24小时动态心电图在中老年心力衰竭患者中的临床应用价值。方法 选取2021年11月至2024年11月我院收治的35例中老年心力衰竭患者作为研究组，同时选取同期35例健康体检者作为对照组。两组均进行24小时动态心电图检测，比较TMR（时间调制率）、LVEF（左心室射血分数）、NT-proBNP（氨基末端脑钠肽前体）、T波电交替（TWA）及动态心电图相关指标，包括标准差正常到正常间期（SDNN）、心率（HR）、均方根差（rMSSD）及全程正常到正常间期标准差（SDANN）。结果 研究组患者的TMR、LVEF显著低于对照组（P<0.05），而NT-proBNP和TWA显著高于对照组（P<0.05）。动态心电图数据显示，研究组的SDNN、rMSSD和SDANN均显著低于对照组（P<0.05），且HR显著高于对照组（P<0.05）。结论 24小时动态心电图在评估中老年心力衰竭患者心脏功能、电活动稳定性及自主神经功能方面具有重要临床价值，值得在临床实践中推广应用。

Abstract

Objective To explore the clinical application value of 24-hour dynamic electrocardiogram in middle-aged and elderly patients with heart failure.
Methods 35 middle-aged and elderly heart failure patients admitted to our hospital from November 2021 to November 2024 were selected as the research group, and 35 healthy persons undergoing physical examination during the same period were selected as the control group. Both groups underwent 24-hour dynamic electrocardiogram testing to compare TMR (temporal modulation rate), LVEF (left ventricular ejection fraction), NT-proBNP (amino-terminal precursor of brain natriuretic peptide), T wave alternans (TWA) and dynamic electrocardiogram. Relevant indicators include standard deviation of normal to normal intervals (SDNN), heart rate (HR), root mean square deviation (rMSSD) and standard deviation of normal to normal intervals (SDANN).
Results The TMR and LVEF of patients in the study group were significantly lower than those in the control group (P<0.05), while NT-proBNP and TWA were significantly higher than those in the control group (P<0.05). Dynamic electrocardiogram data showed that the SDNN, rMSSD and SDANN of the study group were significantly lower than those of the control group (P<0.05), and the HR was significantly higher than that of the control group (P<0.05).
Conclusion   24-hour dynamic electrocardiogram has important clinical value in evaluating cardiac function, electrical activity stability and autonomic nervous function in middle-aged and elderly patients with heart failure, and is worthy of promotion and application in clinical practice.