伊贝沙坦对原发性高血压的疗效及心率变异性的影响

目的 :观察伊贝沙坦对原发性高血压 (EH)的疗效及心率变异性的变化。方法 :原发性高血压患者 40例每日口服伊贝沙坦 1 5 0～ 3 0 0mg,共 8wk。观察血压变化 ,记录用药前后 2 4h动态心电图 ,分析心率变异 (HRV)时域和频域指标 ,并与 3 5例健康对照组比较。结果 :①EH患者应用伊贝沙坦后收缩压 (SBP)和舒张压 (DBP)由 2 1 .62± 0 .47/1 2 .0 1±0 .3 2kPa分别下降至 1 8.9± 0 .3 2 /8.0 1± 2 .3 5kPa,有效率达 73 .1 %。②与对照组相比 ,EH患者相邻正常RR间期标准差 (SDNN) ,正常相邻RR间期差值 (RMSSD) ,相邻正常RR间期差值大于 5 0ms的窦性心律 (PNN50 ) ,高频功率 (HF)明显下降 ,低频功率(LF)不变 ,低频功率 /高频功率 (LF/HF)值增加。应用伊贝沙坦后 ,SDNN、RMSSD、PNN50 、HF增加 ,LF/HF值降低。结论 :原发性高血压患者存在HRV下降 ,而伊贝沙坦在有效降低血压同时提高HRV ,改善自主神经功能失衡。     

缬沙坦对高血压及心率变异性影响的研究

目的:研究缬沙坦对高血压心率变异性的影响。方法:选择80例原发性高血压患者服用缬沙坦,分别在治疗前与治疗14周后进行动态心电图(DCG)及心率变异性(HRV)检查,并与对照组(40例)进行比较。结果:治疗后连续R-R间期标准差(SDNN),相邻R-R均方差(RMSSD),相邻R-R间期大于50ms百分数(PNN50)、高频功率(HF)值均明显上升;低频功率与高频功率比值(LF/HF)显著降低(P<0.01),结论:原发性高血压患者存在HRV下降,而缬沙坦在降压的同时,可提高HRV,改善自主神经功能失调。     

心电图心率变异性参数对急性心肌梗死患者预后的预测价值

目的：探讨心电图心率变异性(HRV)参数对急性心肌梗死(AMI)患者预后的预测价值。方法：回顾性收集2021年10月—2022年12月收治的79例AMI患者的临床资料,根据患者预后情况分为存活组(65例)和病死组(14例),全部患者均接受心电图HRV检测,且病例资料、检查资料完整;对比两组心电图HRV相关参数[RR间期平均值标准差(SDANN)、相邻RR间期差值均方根(RMSSD)、窦性心搏RR间期标准差(SDNN)、0～0.40 Hz总频谱成分(TF)、0.14～0.30 Hz低频成分(LF)/0.15～0.40 Hz高频成分(HF)比值],分析心电图HRV参数预测AMI患者预后不良的风险价值。结果：病死组SDANN,RMSSD,SDNN,TF较存活组低,LF/HF较存活组高,差异有统计学意义(P<0.05)。绘制受试者工作特征曲线(ROC)发现,心电图HRV的SDANN,RMSSD,SDNN,TF,LF/HF参数单独及联合检测预测AMI患者预后不良的曲线下面积(AUC)均>0.70,均有一定价值,其中联合检测预测价值最高。结论：心电图HRV参数对AMI患者预后有较高的预...     

硝苯地平控释片对原发性高血压病患者血压变异性的影响

目的:观察硝苯地平控释片对原发性高血压病患者血压变异性的影响. 方法:临床观察原发性高血压患者99例,用硝苯地平控释片治疗4 wk前后分别采用无创性携带式动态血压监测仪监测动态血压及血压变异性,同时选取49例健康人作对照组观察血压及血压变异性. 结果:99例原发性高血压患者中85例完成观察,治疗前原发性高血压组血压及血压变异性明显比对照明组高(P<0.01),服用硝苯地平控释片后,原发性高血压患者的血压及血压变异性与用药前比较均明显降低(P<0.01).结论:原发性高血压患者血压变异性增高,硝苯地平控释片在稳定降压的同时可降低血压变异性.     

培哚普利对充血性心力衰竭患者心率变异性的影响

目的:观察培哚普利对充血性心力衰竭(congestive heartfailure,CHF)心率变异性(heart rate variability,HRV)的影响,以探讨培哚普利治疗CHF的可能机制.方法:选择24例CHF患者,测量治疗前后HRV各项指标的变化,并与22名健康志愿者进行对照.结果:治疗前CHF患者HRV所有成分除低频功率(LF)/高频功率(HF)外较正常对照者均显著下降(P＜0.001).治疗后培哚普利组正常R-R间期的标准差(SDNN)、节段平均R-R间期的标准差(SDANN)、总功率(TP)、极低频功率(VLF)、LF、HF增加非常显著(P＜0.01),相邻R-R间期差值的均方根(RMSSD)显著增加(P＜0.05),而标准差的平均值(SDNNindex)、相邻R-R间期差值大于50 ms记数占总R-R间期数的百分比(PNN50)有增加趋势,但无统计学意义(P＞0.05);LF/HF有减小趋势,无统计学意义(P＞0.05).结论:培哚普利可以改善心脏自主神经功能的失衡,其作用机制可能与降低交感神经张力、增加迷走神经张力有关.     

冠心病患者动态心电图心率变异性分析

目的分析冠心病患者心率变异性(HRV)各项指标改变差异的临床意义。方法以动态心电图中的时域指标SDNN(连续24 h内正常R-R间期的标准差)、SDANN(全程记录中每5 min正常R-R间期平均值的标准差)、RMSSD(相邻正常R-R间期差值的均方根)、PNN50(相邻R-R间期差值>50 ms百分比)等对200例健康者、501例冠心病患者的心率变异性进行对比研究,并比较2组患者心电图的频域指标总功率(TP)、低频功率(LF)、高频功率(HF)。结果冠心病患者的24 h HRV时域指标明显低于健康对照,其频域指标LF、HF也显著下降。结论冠心病患者HRV降低,提示支配心脏的自主神经功能受损害。     

糖尿病患者心率变异的研究

对30例2型糖尿病患者,25例对照者进行了心率变异性（HRV）的检测。结果表明：糖尿病患者中存在明显的HRV异常,其平均心率增快,平均R－R间期、平均R－R间期标准差、平均R－R间期变异系数及R－R间期大于50ms百分率均明显降低;心率能谱分析中,低频断和高频断的能量均降低,总的趋向是交感神经活动增强．迷走神经作用减弱。表明糖尿病患者HRV变小,自主神经系统活动及心血管系统功能异常。HRV为监测糖尿病患者植物神经功能动态改变提供了一种新的手段。     

氨氯地平治疗原发性高血压疗效分析

氨氯地平是一种长效的二氢吡啶类钙拮抗剂。我们于是2002年2月～2005年2月用氨氯地平对156例老年原发性高血压患进行治疗，观察疗效及安全性，现报告如下。     

虚拟现实技术对急性冠状动脉综合征患者心率变异性及儿茶酚胺水平的影响

目的 观察虚拟现实技术(VR)对急性冠状动脉综合征(ACS)患者心率变异性(HRV)及儿茶酚胺水平的影响.方法 ACS患者62例随机分为治疗组和对照组,每组31例,均接受ACS规范化药物治疗.治疗组穿戴VR 3D眼镜体验睡眠治疗场景,每天1h,治疗7d.比较两组治疗前后HRV指标和外周血儿茶酚胺水平变化.结果 治疗前两组HRV指标和外周血儿茶酚胺及其代谢物水平比较无统计学差异(P＞0.05).治疗7d后,两组窦性RR间期标准差(SDNN)、RR间期平均值标准差(SDANN)、RR间期标准差的平均值(SDNNindex)、相邻RR间期差值的均方根(rMMSD)和高频功率频段(HF)水平均高于治疗前(P＜0.05),低频功率频段(LF)、LF/HF低于治疗前(P＜0.05),外周血儿茶酚胺及其代谢物水平均低于治疗前(P＜0.05).治疗7d后,治疗组SDNN、SDANN、SDNNindex、rMMSD和HF高于对照组(P＜0.05),LF和LF/HF低于对照组(P＜0.05),外周血儿茶酚胺及其代谢物水平低于对照组(P＜0.05).结论 在ACS规范化药物治疗的基础上,患者穿戴VR 3D眼镜体验睡眠治疗场景能够改善HRV,降低外周血儿茶酚胺水平,可作为ACS的辅助治疗方法.     

培哚普利对2型糖尿病合并心脑血管疾病心率变异性的影响

目的　研究血管紧张素转换酶抑制剂培哚普利 (perindopril)对 2型糖尿病合并心脑血管疾病患者心率变异性 (heart rate variability,HRV)的影响。方法　 35例 2型糖尿病合并心脑血管疾病者服培哚普利 (4～6 mg/ d,8周 ) ,前后行 2 4 h动态心电图检查 ,分析心率功率谱时域和频域指标。结果　培哚普利使 HRV时域指标正常 RR间期的标准差 (SDNN)、每连续 5 min时段标准差 (SDANN) ,相邻 RR间期之差的均方根值 (r MSSD)和频域指标高频 (HF)显著增加 ,频域指标总频谱 (TF) ,低频 (L F)和 L F/ HF明显降低。结论　培哚普利对糖尿病合并心脑血管疾病患者心率变异性产生有益的作用 ,并对预防心脑血管疾病再发有重要意义     

Effects of atropine on the time and frequency domain estimates of blood pressure and heart rate variability in mice

1. Indices quantifying blood pressure (BP) and heart rate (HR) variability have been recently developed and may be used to assess the contribution of the autonomic nervous system to cardiovascular fluctuations. 2. Cardiovascular variables were measured in eight conscious mice equipped with a BP telemetric device. Each recording session was conducted when the mice were at rest and included a control period, an injection of atropine methylnitrate (2 mg/kg) and a post-treatment recording. 3. Time domain indices were the mean pulse interval (PI) and NN (the normal-to-normal intervals), mean HR, standard deviation of PI (SDNN), the square root of the mean of the sum of the squares of differences between adjacent PI (RMSSD) and the pNN8 (NN8 count divided by the number of NN intervals). Frequency domain indices of HR variability were the low frequency (LF) zone (0.15-0.60 Hz) and the high frequency (HF, respiratory sinus arrhythmia) zone (2.5-5.0 Hz) of the PI power spectrum. The time domain index of spontaneous baroreflex sensitivity (BRS) was the slope of the linear PI and systolic BP relationship obtained using the sequence technique. The frequency domain indices of BRS were the gain of the transfer function between systolic BP and PI in the LF and HF bands. 4. Atropine markedly affected these variables, illustrating vagal predominance under resting conditions in mice. The preferable time and frequency domain indices for quantifying the vagal contribution to HR variability were the pNN8 and the LF gain.     

脑卒中患者心率变异性特征研究

目的 观察脑卒中与非脑卒中患者的心率变异性(heart rate variability,HRV),探讨脑卒中对HRV的影响.方法 选择2012年7月—2013年9月收治的72例脑卒中作为观察组,选择同期住院的非脑血管疾病患者80例作为对照组.对两组进行24 h的HRV监测,于入院后24 h和治疗1个月后分别进行监测,观察两组HRV的变化情况.结果 观察组在入院后24 h和治疗1个月后全程全部窦性R-R间期的标准差(SDNN)、24 h内每5分钟时段窦性R-R间期平均值的标准差(SDANN)、全程全部窦性R-R间期的平方根(rMSSD)、两个相邻R-R间期互差>50 ms的心跳次数所占分析信息间期内心搏数的百分比(PNN50)、总功率谱(TP)、低频功率谱(LF)、高频功率谱(HF)较对照组降低,LF/HF较对照组增高(P<0.05);观察组治疗1个月后SDNN、SDANN、rMSSD、PNN50、TP、LF、HF较入院后24 h升高,LF/HF较入院24 h降低(P<0.05).观察组入院24 h日间和夜间HRV比较差异无统计学意义(P>0.05);观察组治疗1个月和对照组夜间HRV均高于日间(P<0.05);观察组治疗1个月后日间和夜间SDNN、SDANN、rMSSD、PNN50、夜间LF、夜间HF并较入院24h时均显著升高,LF/HF、TP、日间LF、日间HF较入院24 h时降低(P<0.05).结论 脑卒中患者HRV昼夜间波动节律减弱或消失,植物神经功能受损严重,随着治疗时间的延长,迷走和交感神经间逐渐平衡调控,HRV节律逐步恢复.     

Comparison between pre-prandial and post-prandial heart rate variability (HRV)

After food ingestion, peptides are released in GIT, which cause local vasodilatation. Therefore, after meals, redistribution of blood occurs because of shifting of large amounts of blood into GIT. In normal individuals, this is well compensated and does not lead to post-prandial hypotension. The mechanism of post-prandial hypotension is well known. We hypothesized that there may be a decrease in parasympathetic activity (tone) after meals to compensate for the change in blood distribution. We carried out the study to find out the changes in the autonomic tone before and after meals (lunch) in normal individuals, using Heart Rate Variability (HRV). From the series of RR intervals marked, the time domain and frequency domain measures of HRV were obtained using Nevrokard software (version 6.4). Continuous ECG was recorded in 15 healthy adult subjects (mean age 29.06 +/- 6.2; 13 males and 2 females). The ECG was recorded in pre-prandial and post-prandial state for a period of five minutes each as follows: (1) just before the subjects had lunch, (2) 15 minutes after lunch, (3) 1 hour after lunch, and (4) 2 hours after lunch. Time domain and frequency domain measures of HRV were compared between pre-prandial state and rest of post-prandial states. The autonomic tone parameters did not show a significant change between the pre-prandial state and the immediate post-prandial state. [Range, i.e., the difference between the maximum and minimum RR intervals (406 +/- 161.14 vs. 416.66 +/- 125), standard-deviation of normal to normal RR interval (56.33 +/- 22.72 vs. 67.63 +/- 26.50), RMSSD (55.02 +/- 35.85 vs. 63.87 +/- 32.60), NN50 (42.13 +/- 29.43 vs. 51.86 +/- 29.83), PNN50 (12.67 +/- 10.29 vs. 15.27 +/- 9.71), HF (49.53 +/- 15.10 vs. 47.07 +/- 16.88), LF (41.41 +/- 13.18 vs. 46.49 +/- 15.99), LF/HF (0.98 +/- 0.53 vs. 1.26 +/- 0.90), total power (148.27 +/- 37.78 vs. 137.61 +/- 37.10)]. No significant change was seen in the above parameters between the pre-prandial state and the later phases of post-prandial state. Since there is no significant decrease in the time domain measures and the HF value between the pre-prandial and the post-prandial states, we conclude that the parasympathetic tone is not altered. The parameters denoting sympathetic tone, ie, LF and LF/HF, also do not show a significant change. This indicates that the cardiovascular autonomic tone is not affected by ingestion of meals in normal individuals. Thus we refute our hypothesis. In conclusion, the HRV parameters do not alter significantly after meals in normal individuals.     

Ⅱ型糖尿病患者心率变异时域分析的临床价值探讨

对60例Ⅱ型糖尿病患者HRV时域分析各项指标（SDNN、SDSD、SDANN、RMSSD及PNN50）进行了测定，并与60例正常成人进行对比分析。结果显示Ⅱ型糖尿病患者HRV各项时域分析指标均明显低于正常对照组（P＜0．01）。表明HRV各项时域指标的测定，有利于评价Ⅱ型糖尿病患者的自主神经病变。     

Effect of two selected yogic breathing techniques of heart rate variability

The heart rate variability (HRV) is an indicator of the cardiac autonomic control. Two spectral components are usually recorded, viz. high frequency (0.15-0.50 Hz), which is due to vagal efferent activity and a low frequency component (0.05-0.15 Hz), due to sympathetic activity. The present study was conducted to study the HRV in two yoga practices which have been previously reported to have opposite effects, viz, sympathetic stimulation (kapalabhati, breathing at high frequency, i.e., 2.0 Hz) and reduced sympathetic activity (nadisuddhi, alternate nostril breathing). Twelve male volunteers (age range, 21 to 33 years) were assessed before and after each practice on separate days. The electrocardiogram (lead I) was digitized on-line and off-line analysis was done. The results showed a significant increase in low frequency (LF) power and LF/HF ratio while high frequency (HF) power was significantly lower following kapalabhati. There were no significant changes following nadisuddhi. The results suggest that kapalabhati modifies the autonomic status by increasing sympathetic activity with reduced vagal activity. The study also suggests that HRV is a more useful psychophysiological measure than heart rate alone.     

Heart rate variability in normotensive subjects with family history of hypertension

Hypertension (HT) is a major silent disease affecting young people because of their hereditary and modern lifestyles. Target organ damages occur before overt hypertension is diagnosed. Many offspring of HT parents show early changes in their cardiovascular autonomic functions. Heart rate variability (HRV) provides a window to understand the cardiac autonomic balance. This study was designed to quantify and to compare the HRV among the normotensive young male offspring without history of parenteral hypertension & diabetic (control group, n = 25, age 20.8 +/- 2.4, BMI 24.4 +/- 3.1) with parenteral history of hypertension & non diabetic (study group n = 25, age 19.7 +/- 1.9, 24.05 +/- 3.5). Blood pressure, heart rate (HR), indices of short term HRV during supine rest and quiet standing, HR variation during timed controlled deep breathing was compared between the two groups. There were significant difference in low frequency (LF) power, HF power, total power. LF and HF expressed also in normalized units at rest and standing. In time domain standard deviation of normal to normal RR interval (SDNN) at supine rest and standing were significant. Respiratory sinus arrthymia (RSA), HF in normalized units, deep breathing difference (BDD) and the ratio of maximum RR to minimum RR were also significant in the control group than study group. In the present study there was an increased sympathetic and decreased parasympathetic activity in the study group. These findings are an early marker of cardiovascular autonomic impairment in subjects with parenteral history of hypertension.     

Effects of thiopental and propofol on heart rate variability during fentanyl-based induction of general anesthesia

Anesthetics depress the autonomic nervous system. The effects of thiopental and propofol on heart rate variability (HRV) during fentanyl-based induction of general anesthesia were studied in one hundred patients. We observed different effects of fentanyl, thiopental and propofol on HRV. Fentanyl decreased total power of HRV and low frequency power (LF), but not high frequency power (HF), indicating a greater reduction of cardiac sympathetic activity. Thiopental and propofol caused the further reduction of HRV and decreased HF power. Thiopental increased LF power and LF/HF ratio, indicating that the vagolytic effect is associated with the increase in sympathetic activity. Propofol preserved the LF power, indicating that the cardiac parasympathetic activity is reduced more than the sympathetic activity.     

Effects of atenolol and losartan on baroreflex sensitivity and heart rate variability in uncomplicated essential hypertension

Baroreflex sensitivity (BRS) and heart rate variability (HRV) are potential therapeutic targets. The present study was conducted to assess changes in BRS and HRV after monotherapy with losartan versus that of atenolol in uncomplicated essential hypertension. Thirty subjects with uncomplicated essential hypertension were randomized to receive atenolol 50 mg to 100 mg (n = 15) or losartan 50 mg to 100 mg (N = 15) daily for 6 months. Instantaneous systolic blood pressure (SBP) and heart rate were assessed using servo-controlled infrared finger plethysmography before treatment and at the end of 3 months and 6 months after treatment. The fluctuation in SBP and interpulse interval (IPI) was divided into three specific frequency ranges by fast Fourier transform as high frequency (HF; 0.15 Hz-0.4 Hz), low frequency (LF; 0.04 Hz-0.15 Hz), and very low frequency (VLF; 0.004 Hz-0.04 Hz). The BRS was expressed as (1) SBP-IPI transfer function with its magnitude in the HF and LF ranges and (2) BRS index alpha. The HRV was expressed as total power and power in the LF and HF ranges of interpulse interval. Blood pressure was reduced to a similar extent in both groups. Compared with the baseline, BRS did not improve in both groups at month 3. However, BRS was significantly improved in the losartan group (P < 0.05) but not in the atenolol group at month 6. In addition, BRS was significantly higher in the losartan group than the atenolol group at month 3 and month 6 (P < 0.05). Moreover, heart rate variability was significantly reduced in the atenolol group at month 6 (P < 0.05), but not in the losartan group. The HRV in the losartan group was significantly higher than that in the atenolol group at month 6 (P < 0.05). These findings suggest superior effects of losartan on BRS and HRV than atenolol in uncomplicated essential hypertension, which may be beyond blood pressure reduction/resetting.