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| Evaluation of Cardiac Autonomic Nerve Function in Patients with Primary Hyperthyroidism in Terms of Dynamic Electrocardiogram |
| ZHU Yao, RUAN Xue-lian, QIAN Dong, et al |
| Jiangsu Province Hospital of TCM, Nanjing,210000,China |
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Abstract 【Objective】Evaluation of cardiac autonomic nerve function in patients with primary hyperthyroidism in terms of dynamic electrocardiogram.【Methods】A total of 44 patients with primary hyperthyroidism admitted to Jiangsu Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were selected as the observation group, while 44 people matched with age and sex at the same period were selected as the control group. The changes of heart rate(HR) variability(SDNN, SDNN Idx, PNN50, rMSSD, SDANN, triangle index); cardiac chronological function indexes (maximum HR, minimal HR, difference between the maximum and minimal HR, 24-hour average HR, daytime average HR, nocturnal average HR and circadian rhythm of HR) were compared in the two groups, and the correlation between chronological function indexes and heart rate variability(HRV) indexes was analyzed in the observation group. 【Results】 (1) The time-domain indexes of HRV including SDNN, SDNN Idx, PNN50, rMSSD, SDANN and triangle index in the observation group were significantly lower than those in the control group (P<0.05). (2) There was no significant difference in the maximum HR between two groups (P=0.138), however, minimal HR and difference between the maximum and minimal HR in the observation group were higher than those in the control group (P<0.001,P=0.004). 24-hour average HR, average daytime HR and average nighttime HR in the observation group were higher than those in the control group (P<0.05). (3) In the observation group, all the chronotropic functional indexes except for maximum HR were mainly correlated with SDNN and triangle index. SDNN was negatively correlated with minimal HR (r=-0.771) and with nocturnal average HR (r=-0.790), while the triangle index was negatively correlated with minimal HR (r=-0.729) and nocturnal average HR (r=-0.770). The slowest heart rate, 24-hour average heart rate, night average heart rate of patients with hyperthyroidism were significantly correlated with SDNN, SDANN, rMSSD and triangular index (all P<0.05), and the difference between the fastest and slowest heart rate was significantly correlated with SDNN and triangular index (All P<0.05), there was a significant correlation between the average daytime heart rate and SDNN, rMSSD and triangle index (all P<0.05). 【Conclusion】There is a significant imbalance in the regulation of cardiac autonomic nerve system in patients with hyperthyroidism, which is characterized by double damage of sympathetic nerve and vagus nerve, in which the over activation of sympathetic nerve is more serious.
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Received: 19 April 2021
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[1] 郭辉.关注甲状腺功能异常引起的心血管损害[J].临床内科杂志,2019,36(8):521-523.
[2] 王文君, 程秋实. 甲状腺功能亢进并发甲亢性心脏病的危险因素分析[J].现代仪器与医疗,2017,23(5):43-44.
[3] 王惠歆, 宿燕岗. 心脏变时功能不全的研究进展[J].中国心脏起搏与心电生理杂志,2015,29(6):574-578.
[4] 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南——甲状腺功能亢进症[J].中华内科杂志,2007,46(10):876-882.
[5] BEN-DOV I Z, KARK J D, BEN-ISHAY D, et al.Predictors of all-cause mortality in clinical ambulatory monitoring: unique aspects of blood pressure during sleep[J].Hypertension,2007,49(6):1235-1241.
[6] FALCONE C. Time-domain heart rate variability in coronary artery disease patients affected by thyroid dysfunction[J].Int Heart J,2014,55(1):33-38.
[7] TUDORAN C, TUDORAN M, VLAD M, et al. Alterations of heart rate variability and turbulence in female patients with hyperthyroidism of various severities[J].Niger J Clin Pract,2019,22(10):1349-1355.
[8] BESSON C, SAUBADE M, GREMEAUX V, et al. Heart rate variability: methods, limitations and clinical examples[J].Rev Med Suisse,2020,16(701):1432-1437.
[9] BAIREY MERZ C N, ELBOUDWAREJ O, MEHTA P. The autonomic nervous system and cardiovascular health and disease: A complex balancing act[J].JACC Heart Fail,2015, 3(5):383-385.
[10] PALAU P.Chronotropic incompetence predicts distance walked in six-minute walk test in heart failure with preserved ejection fraction[J].J Card Fail,2020,26(11):1024-1025. |
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2021, Vol. 38 
