Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation
Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation
复制标题
布鲁格达综合征心率变异性昼夜节律变化的恶化可能导致心室颤动的发病机制
DOI：
10.1016/j.jjcc.2013.12.001
复制
发表时间：
2013
期刊：
影响因子：
2.5
通讯作者：
Kihara Y.
中科院分区：
文献类型：
--
作者：
Tokuyama T;Nakano Y;Awazu A;Uchimura-Makita Y;Fujiwra M;Watanabe Y;Sairaku A;Kajihara K;Motoda C;Oda N;Kihara Y.
目的交感神经支配异常触发心室颤动。我们研究了Brugada综合征（Brs）患者自主神经系统的昼夜节律变化及其与VF风险分层的相关性。方法我们招募了12名男性Brs患者，记录VF（Brs-S;平均年龄42 ± 4岁），17名无记录VF（Brs-N;平均年龄48 ± 4岁），16名年龄和性别匹配的对照。结果Brs-S组和Brs-N组的低频成分（LF）和高频成分（HF）均显著低于对照组（409.8 ± 128.6 ms 2，329.5 ± 108 ms 2 vs. 945.3 ± 111.3 ms ~ 2; 135.1 ± 73.8 ms ~ 2 vs. 391.8 ± 63.9 ms 2）。Brs患者LF和LF/HF的昼夜节律性降低，LF/HF的标准差（SD）<2.5和LF的标准差（SD）<400 ms ~ 2对Brs的诊断具有足够高的敏感性（96.6%）和特异性（92.9%）。Brs-S患者（83.3%）分布在散点图SD/HF均值= SD/LF均值的直线下方。结论Brs缺乏自主神经功能的昼夜节律变化，这可能是VF发病的重要原因。
AimsAbnormal sympathetic innervation triggers ventricular fibrillation (VF). We examined the circadian variation of autonomic nervous system and its relevance to risk stratification of VF in patients with Brugada syndrome (Brs).MethodsWe enrolled 12 male Brs patients with documented VF (Brs-S; mean age, 42 ± 4 years), 17 without documented VF (Brs-N; mean age 48 ± 4 years), and 16 age- and gender-matched controls. The clinical data, 12-lead electrocardiography (ECG), signal-averaged ECG, electrophysiological study (EPS), and heart rate variability from 24 h Holter ECG were compared between the groups.ResultsThe low frequency components (LF) in Brs-S and Brs-N and high frequency components (HF) in Brs-S patients were significantly lower than in the controls (409.8 ± 128.6 ms2, 329.5 ± 108 ms2vs. 945.3 ± 111.3 ms2; 135.1 ± 73.8 ms2vs. 391.8 ± 63.9 ms2, respectively). The circadian variation of the LF and LF/HF decreased in the Brs patients, the standard deviation (SD) of LF/HF (<2.5) and SD of LF (<400 ms2) had sufficiently high sensitivity (96.6%) and specificity (92.9%) for the diagnosis of Brs. Most of the Brs-S patients (83.3%) were located under the line formed by the SD/mean of HF = SD/mean of LF in the scatter plots.ConclusionLack of the circadian variation of autonomic function occurs in Brs, and this may contribute to the pathogenesis of VF.