分析心率变异性与冠状动脉病变的关系

目的 探讨CAD患者HRV与冠状动脉病变之间的关系.方法 回顾分析102例CAD患者的临床资料.结果 冠状动脉病变程度增加,反映交感神经系统功能的HRV指标明显降低有统计学意义.结论 HRV与冠状动脉病变程度之间存在相关性,HRV检测可为临床诊断提供依据,对进一步评估、治疗具有重要意义.     

冠状动脉病变与心率变异性的关系

目的　研究冠心病 (CHD)患者冠状动脉不同病变程度与心率变异性 (HRV)的关系。方法　CHD组 31例 ,行选择性冠状动脉造影 (CAG)。正常对照组 2 7例。两组均行动态心电图监测 ,取得HRV时域和频域指标。结果　CHD组HRV各项指标均低于对照组 ,具有统计学意义。不同冠脉病变范围和程度HRV具有显著性差异。结论　CHD患者HRV明显下降。HRV能敏感地、定量地反映CHD患者冠状动脉病变程度。     

窦性心率震荡与心率变异性指标在急性冠状动脉综合征患者中变化特征对比

目的 探讨急性冠状动脉综合征（ACS）患者窦性心率震荡（HRT）指标变化特征及其与心率变异性（HRV）的相关性.方法 对60例健康体检者和151例ACS的患者[分为不稳定型心绞痛（UAP）组（71例）和急性心肌梗死（AMI）组（80例）]24 h动态心电图检查结果进行分析,检测HRT指标震荡初始（TO）、震荡斜率（TS）和HRV时域指标24 h窦性R-R间期标准差（SDNN）、全程相邻窦性R-R间期之差的均方根值（rMSSD）、相邻窦性R-R间期相差≥50 ms的心搏数占总窦性心搏数的百分比（PNN50）.比较HRT、HRV指标和HRT异常的发生率在各组间的差异,进一步探讨ACS患者HRT和HRV指标相关性.结果 UAP组和AMI组TO明显高于对照组[（1.31±1.03）％和（1.36±0.93）％比（0.19±0.09）％],TS明显低于对照组[（2.92±1.45）和（2.85±1.61） ms/RR间期比（4.24±2.86） ms/RR间期],差异有统计学意义（P＜0.05）;UAP组和AMI组TO和TS比较差异有统计学意义（P＜0.05）.UAP组和AMI组HRV时域指标SDNN、rMSSD、PNN50明显低于对照组[（116.57±29.47）和（92.36±13.41） ms比（136.25±31.12） ms、（24.93±11.36）和（23.23±8.47） ms比（37.13±14.86）ms、（5.65±2.50）％和（4.53±2.81）％比（9.41±3.12）％],差异有统计学意义（P＜0.05）;AMI组SDNN明显低于UAP组,差异有统计学意义（P＜0.05）;UAP组和AMI组rMSSD、PNN50比较差异无统计学意义（P＞0.05）.UAP组和AMI组HRT异常率明显高于对照组[80.3％（57/71）和88.8％（71/80）比41.7％（25/60）],差异有统计学意义（P＜0.05）.ACS患者TO与SDNN呈负相关（r=-0.276,P=0.029）,而TS与SDNN（r=0.312,P=0.046）、PNN50（r=0.138,P=0.035）、rMSSD（r=0.212,P=0.027）呈正相关.结论 ACS患者HRT、HRV变化从不同方面反映心脏迷走神经的功能受损,二者互相联系又相互独立.     

60例老年2型糖尿病患者心率变异性及血压变异性分析

目的 本研究旨在探索老年男性2型糖尿病患者心率变异性及血压变异性的变化.方法 入选人群均为老年男性,共100例,其中对照组（A组）40例,2型糖尿病组（B组）60例.进行24小时动态心电图及24小时动态血压监测.收集其HRV时域指标、BP及BPV长时变异性指标,之后进行对比分析,了解老年男性2型糖尿病患者心率变异性及血压变异性的变化.结果 与对照组相比,2型糖尿病组HRV时域指标减少（P＜0.05）;与对照组相比,2型糖尿病组BPV增大（dSBPSD、dSBPCV等,P〈0.05）.结论 老年2型糖尿病患者组HRV时域指标减少及BPV增大,提示其心脏自主神经功能受损.这对患者病情的严重程度、治疗、预后进行判断、指导和评估是具有重要价值的.     

冠心病患者心率变异性与血清炎症标志物及冠状动脉硬化病变程度相关性的研究

目的:确定心率变异性(HRV)是否与机体炎症反应程度及冠状动脉粥样硬化程度有关。方法:受试者接受冠状动脉造影检查,采用Gensini评分系统反映冠状动脉病变的严重程度,通过24 h动态心电监测,采用时域分析法测定HRV,测定血清脂蛋白相关的磷脂酶A2(Lp-PLA2)、C-反应蛋白(CRP)、IL-6水平以反映机体炎症反应程度。结果:HRV较低的受试者具有较高的Gensini分值,HRV下降与炎症标志物水平升高相伴随。结论:HRV降低与炎症标志物水平及冠状动脉病变程度有关,说明植物神经功能障碍可能通过增强炎症反应促使冠状动脉硬化的发生。     

高校高教龄教师心率变异性分析及其与血压水平的相关性研究

目的研究高教职业对高教龄教师植物神经功能的影响和损害,并同血压进行相关分析。方法用美国产24hDMI动态心电图检查和HRV分析系统,对82例高校高教龄教师高血压病(EH)患者和63例普通职工(对照组)进行HRV时域及频域分析,获取心率变异性指标并进行相关分析。结果研究组时域指标与频域指标中的高频成分较对照组低,低频成分较对照组高(P<0.05),差异均显著;研究组LF和LF/HF比值均显著高于对照组,SDNAA、HF则显著低于对照组(P<0.05),具有显著性差异;研究组收缩压、MABP分别于SDANN呈负相关;与LF/HF比值呈正相关。结论高教职业对高教龄教师植物神经功能具有影响,高血压患病率明显高于同年龄、同工龄的人群;提示心率变异性各项指标可作为高血压危险性评估的一项有意义的指标。     

老年高教教师心率变异性及其与血压相关关系的研究

为探讨高教职业对老年教师植物神经功能的影响及其与血压的相互关系，我们对我院７０名老年教师进行了心率变异性检测，并同血压进行了相关分析，结果报告如下。１　研究对象及方法１．１　研究对象　以我院７０名在职或离退休的老年教师作为研究对象（研究组）。其中男４...     

脑卒中后睡眠障碍患者心率变异性及血压变异性分析及其临床意义

目的 探讨脑卒中后睡眠障碍患者心率变异性及血压变异性的特点及临床意义。方法 研究对象为2018年8月-2021年8月,就诊于南澳人民医院康复科并明确诊断为脑卒中的130例连续住院患者。采用匹兹堡睡眠质量指数量表(PSQI)将患者分为睡眠障碍组和非睡眠障碍组。对研究对象行24h动态心电血压监测,作心率变异时域和频域分析及24h收缩压标准差(24h SSD)、24h舒张压标准差(24hDSD)、24h收缩压和24h舒张压变异系数分析。结果 ①平均年龄、入院时mRS评分及NIHSS评分存在统计学差异(P<0.05),睡眠障碍组均高于非睡眠障碍组,提示卒中后睡眠障碍可能与高龄及病情的严重程度相关。与卒中后非睡眠障碍组相比,睡眠障碍组患者24h平均心率较高;心率变异性时域指标SDNN、SDANN、rMSSD较低;频域指标LF下降,在血压变异性方面,睡眠障碍组24h舒张压变异性教非睡眠障碍组低,两组之间存在统计学差异(P<0.05);②多因素Logistic回归分析显示,年龄(OR1.066,95%CI 1.013-1.122,P=0.013)、入院时NIHSS评分(OR1.41...     

51例高血压左心室肥厚心率及血压变异性分析

原发性高血压对心脏损害的主要表现是左室肥厚(ＬＶＨ)。业已证明 ,ＬＶＨ是心血管事件的独立危险因素。心率变异 (ＨＲＶ)是窦性心律在一定时间内周期改变的现象[1] 。血压变异性 (ＢＰＶ)表示一定时间内血压波动的程度[2 ] 。近来不少研究均提示两者信号中蕴藏着有关心血管调节功能状态的信息。本文通过观察高血压病患者的ＨＲＶ及ＢＰＶ ,研究其与ＬＶＨ的关系 ,旨在探讨高血压病患者心脏自主神经功能的情况及对靶器官损害 (ＴＯＤ)的影响。对象与方法1　对象　 5 1例原发性高血压患者均选自 1999年 10月至2 0 0 0年 10月在本院体检疗养…     

戒烟对原发性高血压患者血压和心率变异性的影响

目的：探讨戒烟对原发性高血压患者血压和心率变异性的影响。方法将140例初次确诊的原发性高血压男性吸烟患者随机分成戒烟组70例和对照组70例,戒烟组开始戒烟,对照组继续吸烟。两组均选用硝苯地平缓释片20 mg/ Qd为基础降压药物治疗,最后完成研究的患者戒烟组60例,对照组61例。戒烟前及6个月后进行血压变异性和心率变异性检测。结果6个月后戒烟组dSSD、SDNNIndex、RMSSD与对照组比较,差异均有统计学意义（ P〈0.05）。结论戒烟可进一步降低白昼收缩压的变异性和恢复心率变异性,避免自主神经对血压和心率的不利影响。     

The association between blood metal concentrations and heart rate variability: a cross-sectional study

Objectives: Analysis of heart rate variability (HRV) is useful for measuring cardiovascular autonomic function. The effects of blood metals on cardiovascular autonomic function have not been studied extensively. The objective of the present study was to determine the association between the concentrations of blood metals, including toxic and essential trace elements, and cardiovascular autonomic function, based on HRV, in subjects without clinical cardiovascular diseases. Methods: The subjects were public officials and their family members (n = 331) in a district of Seoul, Republic of Korea. Age, height, weight, smoking habits, medical history, blood pressure, electrocardiogram (ECG) recording, and chest X-ray were assessed by means of a self-administered questionnaire and medical examination. Blood metal concentrations (blood Pb, As, and Cd; serum Al, Co, Cu, and Zn) were measured by inductively coupled plasma-mass spectrometry. HRV parameters (low frequency, LF; high frequency, HF; total power spectrum, TPS) were measured with LRR-03 and MemCalc software (GMS, Japan). Results: The concentrations of each of the blood metals were almost within normal ranges. Age and heart rate were negatively associated with LF, HF, and TPS (P< 0.01). Whole-blood Cd concentrations were negatively associated with LF (P< 0.01) and HF (P< 0.05). Serum Zn concentrations were positively associated with LF and TPS (P< 0.01). Conclusion: Our study suggests that levels of blood metals even within normal ranges may affect heart rate variability.     

冠心病患者窦性心率震荡及心率变异性的变化

目的 对冠心病患者窦性心率震荡（HRT）及心率变异性（HRV）指标进行分析,评价冠心病、冠脉病变与HRT、HRV的关系,以及两种指标的相关性.方法 选择经冠状动脉造影证实的冠心病患者103例（A组）,其中稳定性心绞痛（SAP）患者35例（A1组）、不稳定性心绞痛（UAP）患者28例（A2组）、急性心肌梗死（AMI）患者40例（A3组）与有室性期前收缩但无器质性心脏病患者30例为健康对照组（B组）,行常规24 h动态心电图检查,测定HRT指标（震荡起始TO及震荡斜率TS）及HRV各时域指标（SDNN、PNN50、HF）.结果 （1）A组各亚组TO值明显高于B组（-4.17±2.75、-3.16±3.18、-0.96±2.92;-6.30±3.47）,TS值明显低于B组（6.81±3.18、5.12±3.31、3.20±1.71;9.52±3.85）（P＜0.05 or P＜0.01）;A组各亚组HRV各时域指标（SDNN、PNN50、HF）值均明显低于B组（P＜0.05）;（2）在A1组中,TO与冠脉评分呈正相关;TS、SDNN、PNN50、HF与冠脉评分呈负相关,其中与TS相关性最强（r=0.45）;（3）TO与SDNN、PNN50、HF均呈负相关;TS与SDNN、PNN50、HF均呈正相关,其中与HF的相关性相对较强（r=0.47）.结论 （1）冠心病患者HRT现象变钝（TO值升高,TS值降低）,HRV各时域指标降低;（2）在预测冠脉病变严重程度上,HRT参数特别是TS相对HRV指标能更敏感地反映冠脉严重程度;（3）HRT与HRV参数间有相关性,其中TS与HF相关性较强.     

Effects of shift work on QTc interval and blood pressure in relation to heart rate variability

Objectives: There is evidence that shift work contributes to excess cardiovascular mortality. The purpose of this study was to determine the effects of shift work on heart rate-corrected QT (QTc) and blood pressure in relation to heart rate variability (CV_RR). Methods: The study population consisted of 153 male shiftworkers and 87 male day workers who were employed at a copper-smelting plant. The QTc interval, total power spectral density (t-PSD) of 100 RR intervals, PSDs with frequencies of 0.01 Hz–0.15 Hz and 0.15 Hz–0.40 Hz (PSD_LF and PSD_HF), CV_RR, low frequency (LF) component variability and high frequency (HF) component variability (CCV_LF and CCV_HF) and %LF (PSD_LF/(PSD_LF+PSD_HF) ·100) were measured (LF and HF components are thought to reflect the sympathetic and parasympathetic activities, respectively). Results: The QTc interval was significantly longer in the shiftworkers than in the day workers, although there was no significant difference in systolic or diastolic blood pressure between the two groups. Also, the CCV_LF and log(PSD_LF) were significantly depressed in the shiftworkers. In the day workers, the QTc interval was significantly related to the CV_RR, log(t-PSD), CCV_HF, log(PSD_HF),%LF, and log(LF/HF ratio) (partial correlation coefficient r=–0.305, –0.377, –0.312, –0.355, 0.297, and 0.277, respectively). In the shiftworkers only two relations of the QTc interval to non-specific CV_RR and log(t-PSD) were significant. Conclusion: The clear association between long QTc interval and reduced parasympathetic activity observed in the day workers did not exist in the shiftworkers. Rather, the shiftworkers had a selective reduction in sympathetic drive, which may have compensated for prolonged QTc interval due to shift work. On the other hand, the impact of shift work on hypertension remains unclear, although reduced sympathetic drive in the shiftworkers may explain the absence of differences in blood pressure between shiftworkers and day workers to some extent.     

大学生极量运动前后的血压心率变化及影响因素分析

目的 探索青年学生极量运动前后血压心率的反应程度及影响因素.方法 对200名青年大学生采用800m极量跑的运动,于运动前、运动后即刻、5 min、10min时用电子血压计重复测量血压及心率1次.观察性别、运动习惯等因素.结果 青年大学生极量运动800 m后,SBP、DBP及HR均大幅度升高,休息10 min后未恢复;运动前后各时间点的男性SBP均明显高于女性;不常运动组极量运动后即刻的SBP明显高于常运动组,DBP也是如此,但差异不明显.结论 极量跑步运动可导致青年学生的血压和心率大幅增加,女性对运动舒张压的稳定作用更好,常运动者有利于稳定极量跑步运动的血压反应.     

儿童肥胖与心率的关系

目的 探讨儿童肥胖与心率的关系,为改善儿童健康水平提供依据.方法 整群抽取苏州市金阊区小学10 488名7 ～ 13岁儿童为研究对象,测量身高、体重、血压、心率等指标.采用单因素和多因素分析方法,进行肥胖与心率的关联性分析.结果 肥胖组、超重组、体重正常组的心率水平依次为(95.25±13.03),(92.95±12.24),(91.28±12.29)次/min,3组间的差异有统计学意义(P＜0.01).将心率水平按四分位数间距进行四分位,心率水平处于第1,2,3和4分位者的BMI值分别为(17.84±2.90),(18.03±2.89),(18.13±2.88)和(18.31±2.92) kg/m2.与心率＜84次/min者相比,调整了多因素后,心率≥100次/min的儿童患超重和肥胖的危险分别为1.350和1.917倍.结论 儿童肥胖与较快的心率相关,在控制肥胖儿童体重的同时要关注其心率变化.     

餐后血糖水平与冠心病发生的相关性

目的 探讨餐后血糖水平与冠心病发生的相关性.方法 选择血糖水平异常并已行冠状动脉造影的患者85例,按血糖水平将患者分为三组:空腹血糖调节受损(IFG)组28例、糖耐量减低(IGT)组29例及糖尿病(DM)组28例,观察各组冠心病发生率及冠状动脉病变程度,分析三组患者C反应蛋白(CRP)、颈动脉内膜中层厚度(CIMT)、血脂、血压、体重指数(BMI)的变化及与冠心病危险因素的相关性.结果 IGT组和DM组冠心病发生率[分别为79.3%(23/29)、85.7%(24/28)]明显高于IFG组[53.6%(15/28)](P＜0.01),DM组冠心病发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组和DM组2支病变、3支病变发生率均高于IFG组(P＜0.01),DM组2支病变、3支病变发生率高于IGT组,但差异无统计学意义(P＞0.05).IGT组、DM组CRP、CIMT、BMI、三酰甘油(TG)、收缩压(SBP)较IFG组明显升高(P＜0.01或＜0.05),高密度脂蛋白胆固醇(HDL-C)较IFG组明显降低(P＜0.01);DM组CRP、TG、SBP较IGT组升高(P＜0.05),其他指标比较差异无统计学意义(P＞0.05);相关性分析表明,IGT组和DM组餐后2 h血糖与CRP、CIMT、BMI、TG呈显著正相关(P＜0.05或＜0.01),与HDL-C呈显著负相关(P＜0.05或＜0.01).结论 餐后高血糖与冠心病的发生、发展有密切关系,对于IGT患者应尽早予以干预治疗,可有效预防心血管事件的发生.

Abstract：

Objective To investigate the correlation between the level of postprandial blood glucose (PBG)and the incidence of coronary artery disease(CAD). Methods Eighty-five patients performed coronary angiography with abnormal blood glucose levels were divided into 3 groups according the blood glucose levels: impaired fasting glucose(IFG)group(28 cases), impaired glucose tolerance(IGT)group(29cases)and diabetes mellitus(DM)group(28 cases). The detection rate and the extent of CAD were observed. The risk factors of CAD in 3 groups such as C-reactive protein(CRP),carotid artery intima-media thickness(CIMT), blood lipids, blood pressure, body mass index(BMI)and the correlation with CAD were analyzed. Results Sixty-two cases were confirmed CAD by coronary angiography. The incidence rate of CAD in IGT group[79.3%(23/29)]and DM group[85.7%(24/28)]was significantly higher than that in IFG group[53.6%(15/28)](P ＜ 0.01). The incidence rate of CAD in DM group was higher than that in IGT group, but there was no significant difference(P ＞ 0.05). The incidence rate of two-lesion and three-lesion in IGT group and DM group were significantly higher than those in IFG group(P＜ 0.01). The incidence rate of two-lesion and three-lesion in DM group were higher than those in IGT group, but there was no significant difference(P＞0.05). The levels of CRP, CIMT, BMI, triacylglycerol(TG)and systolic blood pressure(SBP)were higher and HDL-C was lower in IGT group and DM group than those in IFG group(P ＜ 0.01 or ＜ 0.05).The levels of CRP,TG and SBP were higher in DM group than those in IGT group(P＜0.05). Correlation analysis showed, in IGT group and DM group,2 h PG had significantly positive correlation with CRP, CIMT,B MI, TG(P＜0.05 or＜0.01), and had significantly negative correlation with HDL-C(P＜0.05 or ＜0.01).Conclusions PBG is closely related with the development of CAD.IGT patients should be intervened as early as possible, which can be effective in preventing cardiovascular events.     

Does shisha smoking affect blood pressure and heart rate?

Aim  The aim of this investigation was to explore the correlation of shisha smoking with blood pressure and heart rate values. Subjects and methods  This is a randomized cross-sectional epidemiological study involving a total of 14,310 adults selected from various regions of Jordan. Well-trained pharmacy students interviewed participants in outpatient settings. The frequencies of water-pipe-smoking males and females in the sample were 21.11% and 10.27%, respectively. Measures of blood pressure and heart rate values were carried out in outpatient settings. For each participant, the systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured three times with 10–15-min intervals in the sitting position and at the resting state. The arterial blood pressure (ABP) was calculated from the measured SBP and DBP. Results  Smokers had significantly higher blood pressure and heart rate values than non-smokers. Both smokers and non-smokers with a positive family history of hypertension had significantly higher values of blood pressure than those with a negative family history. Conclusion  A significant elevation of blood pressure and heart rate was observed among shisha smokers. Current cigarette smoking associated with frequent water pipe smoking resulted in greater elevation in blood pressure measurements among both types of tobacco smokers.     

冠心病中血糖与血清微量元素间的关系分析

对７５例冠心病患者依血糖水平分两组，进行１２种血清微量元素测定，旨在探讨微量元素与冠心病及糖尿病间的相互关系。结果发现锌、铬、锰、硒、钴元素高血糖组较对照组血清水平为低，呈非常显著差异（Ｐ＜０．０ｌ）；铜、镍元素增高，差异显著（Ｐ＜０．０５）；而锶、铁、砷、铅、铝元素两组间无显著差异（Ｐ＞０．１）。表明部分微量元素与冠心病及血糖间存在着密切联系。     

Prospective measurement of blood pressure and heart rate over 24 h in women using combined oral contraceptives with estradiol

Objective

Combined oral contraceptives (COCs) containing ethinyl-estradiol are known to increase blood pressure (BP). We evaluated whether COCs containing estradiol (E2) influence 24-h ambulatory BP and heart rate (HR) in normotensive and normal-weight women.

Study design

Twenty-four-hour BP and HR were measured every 30 min with an ambulatory BP device in 18 normotensive healthy non-smoking women prior to (Days 3–6 of menstrual cycle) and after 6 months of use (Days 20–24 of cycle 6) of a COC containing either a quadriphasic combination of E2 valerate plus dienogest (n=11) or a monophasic association of micronized E2 plus nomegestrol acetate (n=7).

Results

Mean age and body mass index of the final sample were 32.50±7.49 years and 22.87±4.08, respectively. E2-based COCs induced no modification of 24-h systolic BP (+ 1.65±8.34 mmHg; p=.41), diastolic BP (+ 0.04±7.36 mmHg; p=.98), mean BP (+ 0.64±6.42 mmHg; p=.68) or HR (− 0.72±5.86 beats/min; p=.61). Differences were not observed even when daytime or nighttime values were separately considered. Though this was not a comparative study, we did not find differences between the effects of the two formulations (24-h mean BP; p=.699).

Conclusions

These data suggest a neutral effect of estradiol-based COCs on independent risk factors for cardiovascular diseases such as BP or HR.

Implications

BP and HR of normotensive women are not increased by E2-based COCs.