绝经前后健康女性的心率减速力分析

目的：通过分析围绝经期及老年健康女性心率减速力（deceleration capacity,DC）的变化,探讨绝经前后女性 DC 与年龄、昼夜节律的关系及其对心率的影响。方法将239例健康女性按年龄分成两组：围绝经期组（45～55岁,115例）和老年组（56～70岁,124例）。对两组女性行24 h 动态心电图检查,计算机自动测定受试者24 h 及白天（15∶00—20∶00）和夜间（00∶00—05∶00）的 DC、心率加速力（acceleration capacity,AC）值并进行心率变异性（heart rate variability,HRV）分析。结果绝经后,女性24 h 的 DC、AC 绝对值及 HRV 时域指标SDNN 和 rMSSD 均呈下降趋势;两组女性夜间 DC、AC 的绝对值及 rMSSD 值均显著高于白天,夜间 SDNN 值显著低于白天;绝经后 AC 与平均心率的相关系数大于 DC 与平均心率的相关系数。结论DC、AC 与 HRV 检测联合应用能预警绝经前后女性各种心血管疾病和降低心源性猝死的风险。     

抑郁症患者心率减速力与心率变异性的相关陛

目的探讨抑郁症患者心率减速力（Dc）与心率变异性（tmv）的相关性。方法选择80例抑郁症患者和80例正常对照组，进行24h动态心电图监测，离线计算DC、HRV时域指标。结果抑郁症患者的DC值、HRV降低，且Dc与时域指标SDNN、RMSSD、PNN50呈显著正相关（p〈0．01）。结论抑郁症患者的Dc值明显降低，且Dc指标和HRV指标有较好的相关性，DC是一项评估自主神经功能状态的新的可靠指标。     

正常人心率减速力与心率变异性的关系

目的 观察健康人心率减速力(DC)和心率加速力(AC)的昼夜变化规律及其与心率变异性(HRV)之间的关系.方法 80例健康人接受24h动态心电图检查,按其时间段不同而划分为昼间(15:00～20:00)和夜间(00:00～05:00)两个时间段.计算机自动测定其昼夜24h的DC、AC值及心率变异性时域指标(SDNN,R...     

急性冠脉综合征患者的心率减速力与心率变异性之间的关系

目的:研究急性冠脉综合征（ACS）患者心率减速力（DC）的变化及其与心率变异性（HRV）之间的关系。方法:97例ACS患者（ACS组）与99例稳定型心绞痛患者（SAP组）及98例正常人行24小时动态心电图检查，计算机自动测定DC值并进行心率变异性（HRV）分析。结果:ACS组患者中，异常DC的发生率明显高于SAP组和正常对照组；ACS组患者的DC值明显低于SAP组与正常对照组；ACS组患者的DC与HRV密切相关。结论:ACS患者的DC减弱，DC变化与HBV密切相关。     

老年高血压合并糖尿病患者心率变异性及其昼夜变化临床分析

目的研究老年高血压合并糖尿病患者的心率变异性(HRV)及其昼夜变化规律,探讨老年糖尿病患者心脏自主神经变化的临床意义。方法选择87例原发性高血压患者(EH组)及68例高血压合并糖尿病患者(EH+DM组),监测24 h动态心电图,进行HRV时域指标SDNN、SDANN、SDNN Index、RMSSD、PNN50的分析。比较2组间HRV指标的差异以及HRV昼夜指标差异。结果 EH+DM组较EH组24 h、日间、夜间HRV各项指标均明显降低,且有统计学差异;EH组SDNN以及RMSSD呈昼低夜高,但无明显统计学差异,SDNN Index和PNN50仍呈昼低夜高现象(P0.01);EH+DM组SDNN以及RMSSD呈昼高夜低现象(P0.05),SDNN Index和PNN50昼夜间无统计学差异。结论老年高血压合并糖尿病患者HRV显著降低,高血压患者昼夜节律已有明显受损,高血压合并糖尿病患者昼夜节律进一步受损,心脏自主神经功能失调。     

扩张型心肌病患者心率减速力的临床研究

目的:研究心率减速力(DC)在扩张型心肌病(DCM)患者中的变化以及与左室射血分数(LVEF)、心率变异性(HRV)之间的关系。方法:32例DCM患者和34例正常人接受24h动态心电图检查和超声心动图检查,计算机分别测定2组患者的DC、LVEF及HRV时域指标(SDNN,RMSSD)与标化的频域指标(LFn、HFn);比较2组患者的DC、LVEF、SDNN,RMSSD、LFn及HFn,并研究DCM患者的DC与LVEF及HRV各指标之间的关系。结果:DCM患者的DC值明显小于正常对照组(3.3±2.3msvs6.9±1.4ms,P<0.01),其异常DC的发生率高达89.7%,明显高于正常对照组(P<0.01);DCM组患者的DC与LVEF、SDNN、RMSSD、LFn及HFn之间呈明显的正相关关系。结论:DCM患者的DC值明显降低,DC是一项可用以定量评估DCM患者自主神经张力并筛选高危患者的新的可靠指标。     

外伤性骨折患者心率减速力分析

目的探讨外伤性骨折患者心率减速力(deceleration capacity of rate,DC)的变化及其与心率变异性(heart rate variability,HRV)的相关性。方法选择外伤性骨折患者60例,根据年龄分为Ⅰ组(40～60岁)、Ⅱ组(61～80岁),两组患者均进行24h动态心电图检测并计算DC及HRV等各项指标。结果Ⅰ组DC为(6.08±1.74)ms;Ⅱ组DC为(5.13±0.82)ms;DC与HRV指标SDNN、rMSSD、pNN50、HF等呈正相关(P<0.01),与HR呈负相关。结论外伤性骨折患者DC指标和HRV指标相关性较好,DC可独立作为自主神经功能检测的指标。     

冠心病患者心率减速力与心率变异性的相关性观察

选择2012～2013年进行24h动态心电图检查的113例非急性心肌梗死冠心病及100例健康体检者,通过DMS公司动态分析系统检测心率减速力（DC）及连续心率减速力（DRS）,并检测有关心率变异性（HRV）指标。与对照组比较,冠心病组DC、DRS值以及HRV有关指标均降低（P〈0．05）。结论：冠心病组DC值和DRS值明显降低,提示冠心病患者迷走神经功能受损。     

糖尿病患者心率减速力与心率变异性分析

目的探讨心率减速力（decelerationcapacityofhearrate,DC）与心率变异性（heartratevariability,HRV）在评价糖尿病患者自主神经功能方面的应用。方法对73例2型糖尿病患者和65名正常人群对照组进行24h动态心电图检查,离线计算DC、HRV时域指标并进行比较和相关分析。结果2型糖尿病患者的DC及HRV各时域指标均比对照组降低,差异均有统计学意义（P〈0．05）。相关分析结果显示,2型糖尿病组DC与HRV中的总标准差（SDNN）呈正相关（r=O．597,P〈O．01）,与差值均方根（RMSSD）呈正相关（r=O．569,P〈0．01）,与pNN50呈正相关（r=0．501．P〈0．05）。结论DC和HRV各时域指标有较好的相关性,可作为2型糖尿病患者自主神经功能检测的指标。     

高血压并冠心病者心率减速力与HRV的相关性

目的 探讨高血压合并冠心病患者心率减速力(DC)与心率变异性(HRV)的相关性.方法 选择36例窦性心律的高血压合并冠心病患者和40例正常人对照组,进行24h动态心电图检查,应用国内自行研制的DC处理软件,离线计算DC、HRV时域指标.结果 高血压合并冠心病组的DC、HRV降低;且DC与时域指标SDNN、RMSSD、P...     

Effects of cigarette smoking on the circadian rhythm of heart rate variability

BACKGROUND: The effects of cigarette smoking on the circadian rhythm of heart rate variability (HRV) are not known. METHODS: We studied the effects of cigarette smoking on the circadian rhythm of HRV in 24 smoking and 21 non-smoking healthy subjects. Twenty-four hour ambulatory electrocardiograms were recorded and time domain parameters of HRV (SDNN [standard deviation of all R-R intervals], SDANN [standard deviation of the averages of R-R intervals in all 5-minute segments of the entire recording], RMSSD [the square root of the mean of the sum of the squares of differences between adjacent R-R intervals]) were determined for the entire 24-hour period and for each 3-hour period. RESULTS: In total, SDNN and SDANN were significantly lower in smokers than non-smokers (116 +/- 26 vs 136 +/- 27, p < 0.05 for SDNN, 109 +/- 25 vs 121 +/- 24, p < 0.05 for SDANN). However, there were no statistical differences between smokers and non-smokers in heart rate (81 +/- 9 vs 76 +/- 10, p > 0.05) and RMSSD (32 +/- 12 vs 37 +/- 18, p > 0.05). These HRV parameters showed a circadian variation: they increased at night and decreased during the day in both groups. The parameters were lower in smokers than non-smokers during daytime (especially, between 8-14 hours). However, no differences were detected during night-time. CONCLUSIONS: Time domain parameters of HRV (SDNN, SDANN and RMSSD) in both smoking and non-smoking healthy subjects have a circadian rhythm. SDNN and SDANN were lower in smokers than non-smokers during daytime.     

急性重度脑外伤患者自主神经功能变化的研究

为探讨急性重度脑外伤（ASTBI）患者是否存在自主神经（ANS）功能障碍及其临床意义,对30例ASIBI患者（ASTBI组,GCS评分≤8分）于入院1周内进行24小时心率变异性（HRV）检测,动态心电图分析系统自动计算HRV各项指标（包括时域、频域和非线性分析）,绘制HRV直方图、散点图,并与31例正常人（对照组）进行比较。结果 ASTBI组HRV多数指标均明显降低（P＜0．05－0．001）;HRV直方图、散点图;均有特 征性改变,存活者和死亡者的HRV时域分析、频域分析各项指标比较有统计学意义。认为HRV能定量、全面、直观地反映ASTBI患者交感神经和迷走神经的功能状态;ASTBI患者存在明显的ANS功能障碍;ANS功能障碍与病情严重性呈正相关,且常直接影响预后。     

Heart rate variability in healthy children and adolescents is partially related to age and gender.

We evaluated 24-h time-domain heart rate variability (HRV) in 103 (46 females) healthy children and adolescents. Subjects were divided into four male and four female groups (ages 1-5, 6-10, 11-15, 16-20 years) and 24-h ambulatory Holter monitoring was performed. HRV was assessed by SDNN, SDNN index (SDNN-i), SDANN, rMSSD, pNN50. Males showed SDNN and SDANN values significantly higher than females while for SDNN-i, rMSSD, pNN50 there were no significant differences between sexes. With increasing age, there is a progressive and significant decrease of HR and increase of SDANN. On the other hand, SDNN, SDNNi, pNN50 and rMSSD increased significantly only between the first two age-groups. rMSSD and pNN50 were significantly related to body mass index. Thus, SDNN and SDANN, overall HRV measures, increased with age and were gender-related. HRV indices of parasympathetic function (rMSSD, pNN50) and SDNN-i increased up to 10 years of age and were gender-unrelated. These data demonstrate that in healthy children and adolescents there is a progressive modification of HRV that may reflect a progressive evolution of the autonomic nervous system, with different pattern measure-dependent. This paper enables us to compare, in future works, HRV in pediatric subjects in different groups according to the different HRV measures under examination.     

Long-Term follow-up of the circadian rhythm of heart rate and heart rate variability in healthy elderly patients.

BACKGROUND: The long-term age-related changes in circadian rhythm of heart rate variability (HRV), that is, autonomic nervous activity, remain unknown in elderly people. METHODS AND RESULTS: Holter monitoring was conducted twice at an interval of 15 years in 15 healthy elderly patients (age: 70.0 +/- 4.1 years, at first monitoring, female: 10) and assessed the age-related changes in 24-h mean and hourly mean normal sinus R-R interval (mean NN), HRV (high frequency (HF) component, low frequency (LF) component and LF/HF) and the circadian rhythms. As a result, 24-h mean mean NN (0.976 +/- 0.115 vs 0.903 +/- 0.117 (s), p = 0.0019), LF/HF (1.681 +/- 0.731 vs 0.962 +/- 0.442, p = 0.0022), and LF (278.88 +/- 176.43 vs 179.19 +/- 132.33 (ms2), p = 0.0039) significantly decreased 15 years later, although 24-h mean HF (221.20+/-138.89 vs 310.78+/-296.73 (ms2), p = 0.1102) increased slightly. The hourly mean NN closely correlated with hourly HF and LF/HF throughout circadian rhythms both at first and second monitoring. In the morning hours, amplitude rates of all HRV indices increased significantly 15 years later. CONCLUSION: In elderly people, age-related changes in the 24-h mean heart rate (HR) were conversely dissociated from those of the 24-h mean HRV. However, the close correlation between hourly HR and HRV was preserved, even in very elderly patients. Additionally, the amplitude rates in HRV in the morning increased with age. These age-related changes of HR and HRV might be characteristic of elderly people.     

脑梗死患者心率变异性分析(附50例报告)

目的　研究脑梗死患者的自主神经功能状态。方法　应用时域法对 5 0例脑梗死患者进行心率变异性分析。结果　脑梗死组与正常对照组相比所有 R- R间期均值的标准差 (SDNN)明显降低 (10 2 .0 6± 2 8.5 1,137.0 6± 2 9.0 8) ms,P<0 .0 1,HRV三角指数明显降低 (2 5 .86± 9.18,37.5 7± 14 .88;P<0 .0 5 )。相邻 R- R间期之差的均方根值 (RMSSD)、爱丁堡指数 (p NN5 0 )较正常对照组低 ,但无统计学意义。脑梗死患者心率变异昼夜比较RMSSD夜间高于日间 (18.70± 7.30 ,2 6 .2 3± 8.85 ) m s,P<0 .0 5。余指标昼夜有所变化但无统计学意义。脑梗死首次发作组与非首次发作组相比 SDNN、RMSSD、p NN5 0、HRV三角指数等指标无明显差别。结论　脑梗死患者的自主神经功能以交感神经活性占优势 ,心率变异程度降低 ,且失去了正常的昼夜规律。脑梗死后自主神经功能的改变主要与本次发作有关     

糖尿病与冠心病患者心率变异性分析

目的 探讨糖尿病与冠心病患者心率变异（ＨＲＶ）改变及其异同,并观测疾病状态下ＨＲＶ改变的昼夜节律性。方法 观察２５例糖尿病患者、２例冠心病患者及４８名健康人２４ｈ、白天段及夜间段心率变异长程时域。结果 糖尿病组与冠心病组ＨＲＶ各指标ＳＤＮＮ、ＲＭＳＳＤ、ＰＮＮ５０、ＳＤＡＮＮ均显著低于健康对照组（Ｐ〈０．０１）。糖尿病组与冠心病组及２组内白天与夜间ＨＲＶ各指标比较均无显著性差异。结论 糖尿病、冠心     

Twenty-Four Hour Time Domain Heart Rate Variability and Heart Rate: Relations to Age and Gender Over Nine Decades

Objectives. This study sought to define the effects of age and gender effects on the normal range of time domain heart rate variability (HRV) over nine decades in healthy subjects.Background. Low HRV is considered an independent marker of mortality risk. However, the age-related decline in HRV may limit its predictive value, particularly in the elderly. Delineation of the range of HRV in healthy subjects over the life span is needed. Gender-related differences in HRV also need clarification.Methods. We determined, according to decade, 24-h heart rate (HR) and HRV of 260 healthy subjects (10 to 99 years old; 112 male, 148 female) by means of five standard time domain measures: standard deviation of all normal sinus RR intervals over 24 h (SDNN), standard deviation of the averaged normal sinus RR intervals for all 5-mm segments (SDANN), mean of the standard deviations of all normal sinus RR intervals for all 5-min segments (SDNN index), root-mean-square of successive normal sinus RR interval difference (rMSSD) and the percentage of successive normal sinus RR intervals >50 ms (pNN50).Results. 1) HRV decreased with aging, the pattern of change being measure dependent. HRV (SDNN and SDANN) decreased only very gradually, reaching 60% of baseline (second-decade values) by the tenth decade. With the SDNN index, HRV decreased linearly with aging, reaching 46% of baseline by the tenth decade. Using pNN50 and rMSSD, HRV decreased most rapidly, reaching 24% and 47% of baseline, respectively, by the sixth decade and then stabilized. 2) Using the SDNN index, rMSSD and pNN50, HRV of subjects >65 years old fell below published cutpoints for increased risk of mortality in 25%, 12% and 4%, respectively. 3) At age <30 years, HRV for all measures was lower in female than male subjects. Gender differences decreased at age >30 years and disappeared at age >50 years. 4) HR also declined with aging but much more slowly. HR at age <50 years was faster in female than in male subjects. Gender differences disappeared thereafter.Conclusions. 1) Using all measures, HRV of healthy subjects declines with aging, with measure-dependent patterns. 2) Using the SDNN index, rMSSD and pNN50, HRV of healthy subjects, particularly those >65 years old, may decrease to below levels associated with increased risk of mortality. 3) Gender influences HRV. Gender differences in HRV are age and measure dependent. 4) Age and gender also affect heart rate.     

急性心梗患者心率减速力与心率变异性

目的:探讨急性心肌梗死(AMI)患者心率减速力(DC)与心率变异(HRV)、心率震荡(HRT)的相关性.方法62例窦性心律的AMI患者和51例非AMI对照组进行24h动态心电图检查,离线计算DC、HRV时域指标、HRT的两个参数震荡初始(TO)和震荡斜率(TS).结果:AMI患者的DC值、HRV降低;HRT减弱;且DC...