157例正常成年人的心率变异分析（摘要）

１５７例正常成年人的心率变异分析（摘要）田小园，王丽丽，霍丽，程硕慆，郭跃萍心率变异（Ｈｅａｒｔｒａｔｅｖａｒｉａｂｉｌｉｔｙ，ＨＲＶ）描述心脏节律变化，通常指窦性心律不齐的程度。其生理学基础是自主神经系统活性及其与心血管系统用互制约的关系。ＨＲＶ分...     

短程心率变异与长程心率变异对比分析

目的　探讨短程心率变异在临床应用的价值。方法　短程心率变异性测试采用床旁一分钟的测试方法 ,即受测试者佩带Holter记录盒后立即卧床 ,深呼吸 ,用心电图机连续描记一分钟的心电图 ,测试RR间期 ,如果RR间期所对应的快慢心率相差 10次以上为正常 ,低于或等于 10次为异常。结果　 (1)正常人短程心率变异性与高血压冠心病患者短程心率变异有显著差异 ;(2 )正常人长程心率变异时域指标分析与唐海沁等健康人心率变异时域法正常值分析结果相符 ;(3)短程与长程心率变异异常发生率无显著性差异 (P >0 0 5 )。     

40岁以上正常人的心率变异分析

报告５０例正常人的心率变异分析。按参数间密切相关将６项频域、１０项时域参数分成三组：总频成分（ＴＯＴ）、超低频成分（ＵＬＦ）、极低频成分（ＶＬＦ）、连续５ｍｉｎ正常Ｒ－Ｒ间期标准差均值（ＡＳＤ）；高频成分（ＨＦ）、相邻正常Ｒ－Ｒ间期差值均方根（ＲＭＳＳＤ）、相邻正常Ｒ－Ｒ间期超过５０ｍｓ正常Ｒ－Ｒ间期均值的标准差（ＳＤＡ）、ＳＤＡ的心率较正值（ＳＤＡＣ）。健康男性ＳＤ显著高于女性，女性ＲＭＳＤＣ显     

正常孕妇5min短程心率变异分析

目的 观察正常妊娠妇女的5min短程心率变异,探讨用5min心率变异中的TP值作为衡量妊娠妇女心血管自主神经功能平衡情况的可能性.方法 在我院门诊及住院的25～35岁妊娠妇女中随机选择97例健康妇女作为观察组,未妊娠妇女中选择46例健康妇女作为对照组.对143例均分别进行5min短程心率变异分析.结果 观察组妊娠妇女5min短程心率变异分析频域指标TP值较对照组妊娠妇女明显降低(P＜0.05).结论 5min短程心率变异分析可以作为衡量妊娠妇女心血管自主神经功能平衡情况的检查.     

正常儿童的短程心率变异

为了解正常儿童短程心率变异(HRV)的数据,对216例正常儿童进行短程HRV检测,按不同年龄分4组进行。分别测量SDNN、MSD、rMSSD、PNN_(50)、HRVI等时域数据和频域值LF/HF作组间比较。显示在不同年龄组间时域值存在显著性差异(P<0.05),且男比女大。频域值在组间无显著性差异(P>0.05)。各HRV值与年龄呈不同程度的正相关,r=0.1644～0.3011(P<0.05)。且随年龄增加数值相对增大。频域值LF/HF无性别的显著差异,±D为1.93±1.28。提示在儿童期的HRV值比正常成人低,随年龄增长HRV值才逐渐增大。     

国内正常中老年人心率变异性分析

国内正常中老年人心率变异性分析上海市纺织局第二医院（２０００９０）王国梁张青许其陈静我们对２６３例健康中老年人的心率变异性分析（ＨＲＶ）以时域分析法进行测算，得出正常值范围，并进一步分析了中老年人ＨＲＶ的差异，对其意义作了初步探讨。１对象和方法１．１...     

高血压病患者的心率变异分析

高血压病患者的心率变异分析山东省立医院（２５００２１）綦彦鲁，刘同宝济南医院董嘉本文通过对高血压患者的心率变异分析，揭示其植物神经功能变化情况，以指导临床治疗。资料与方法：选择高血压病人３４例，男２０例、女１４例，年龄４０～６０岁，排除合并糖尿病、冠...     

正常孕妇24小时的心率变异分析

为观察正常孕妇的HRV以及室性心律失常的发生率 ,探讨孕妇心脏自主神经功能的平衡情况 ,对 6 9例孕妇(按妊娠周期分成 3组 )和 30例正常未孕妇女进行 2 4h动态心电图检查 ,监测 2 4h的室性心律失常 (PVC) ,对其时域、频域结果进行分析。结果显示 :与对照组相比 ,怀孕各组大部分时域、频域指标均明显降低 (P <0 .0 5 ) ,但与妊娠周期无关 ;而怀孕伴PVC与怀孕无PVCHRV比较有显著性差异 (P <0 .0 5 )。提示怀孕伴PVC可能与心脏自主神经功能失衡有关。HRV分析对临床评价孕妇心脏自主神经功能有一定的参考意义。     

健康人心率变异时域法正常值分析

为了解国人心率变异(HRV)时域法指标正常值,检测1524例17—94岁健康人24h动态心电图,分析HRV时域法5项指标。结果显示:(1)SDNN、SDANN、SDNN_(Index),rMSSD和PNN_(50)均值分别为127±33、116±32、49±14、29±12(ms)和8±9％,与国内研究一致。(2)HRV时域法各指标随年龄增加而降低(r=0.30——0.48,P<0.01),中青年组与老年组HRV差异有显著意义(P<0.01)。(3)男性SDNN、SDANN和SDNN_Index大于女性(P<0.05),而rMSSD和PNN_(50)小于女性(P<0.05)。SnNN、SDANN、SDNN_(Index)和rMSSD单侧下限值分别为73、64、26和9ms,PNN_(50)呈偏态分布,临床意义有待探讨。     

心率变异临床应用分析

心率变异 (ＨＲＶ)是指窦性心率在一定时间内周期性改变的现象。ＨＲＶ受自主神经系统即交感神经系统和副交感神经系统的共同控制 ,同时也公认ＨＲＶ分析是判断自主神经活动的常用定量指标 ,ＨＲＶ降低是预测心脏病患者死亡的独立危险因子 ,有十分重要的研究价值[1 ] 。为进一步探讨ＨＲＶ的临床应用 ,现将我院 2 4ｈ动态心电图 (ＤＣＧ)同时观察ＨＲＶ结果作一回顾性分析。1　资料与方法我院 1999年 10月～ 2 0 0 0年 8月ＤＣＧ共检测患者 2 0 5例 ,其中男 10 8例、女 97例。冠心病 47例、高血压病 2 1例心律失常 5 0例、心肌梗死 16例、心…     

Heart Rate Variability for Evaluating Surgical Stress and Development of Postoperative Complications

Heart rate variability (HRV) has recently been used to detect autonomic nerve tone, which is affected by various stresses. To test out hypothesis that HRV can determine surgical stress, we examined perioperative HRV in 30 patients with surgical treatment. Relations between HRV and factors of surgical stresses, such as duration of the operation, amount of blood loss at the operation, and developments of complications, were evaluated. Mean heart rate (HR) increased and other HRV indices decreased postoperatively. Most indices correlated significantly to the duration of the operation and amount of blood loss at the operation on postoperative day 1. Only the standard deviation of normal to normal RR intervals (SDNN) and HRV triangular index showed significantly low values in complicated patients. HRV measurement in the perioperative period showed a significant relation to surgical stress. The present results indicated that HRV may provide useful information with respect to surgical stress.     

床旁一分钟心率变异测试与Holter心率变异测试两种方法的临床研究

目的：对床旁一分钟心率变异（HRV）测试方法进行临床研究,并与Holter测试HRV相比较,探讨其可行性,实用性,方法：采用美国第69届心脏病学会议上Umetani提出的床旁一分钟深呼吸时HRV测试方法（下述简称一分钟法）和Holter 24小时心电监测HRV（下述简称Holter法）,对62例健康人和58例冠心病心绞痛患进行测试,结果：62例健康人中一分钟法HRV正常53人（87．1％）,Holter法HRV正常58人（93．5％）,P＞0．05,58例冠心病心绞痛患中,一分钟法HRV正常40人（68．9％）,Holter法HRV正常46人（79．3％）P＞0．05,结论：一分钟法与Holter法测定无明显差异,两种方法效果相同。     

Short-Term Adjuvant Atorvastatin Improves Frequency Domain Indices of Heart Rate Variability in Stable Systolic Heart Failure

The autonomic nervous system marks beneficial drug responses in systolic heart failure management. The impact of statin therapy in this broad disease class is unclear and patient studies are extremely limited.Methods: We studied a group of 23 patients with stable systolic ventricular impairment and randomised them single (patient) blind to high dose Atorvastatin 40 mg daily or placebo in addition to standard therapies over a 12-week treatment interval. Impact on the autonomic nervous system was assessed by anonymised short-term (20 min) standardised supine heart rate variability analyses.Results: Two subjects withdrew one due to decompensation and one due to gastric intolerance. The remaining subjects completed both monitoring events without changes in standard medicines. Frequency domain but not time domain HRV indices improved with active statin therapy suggesting beneficial effects in attenuating sympathetic tone.Conclusions: In this small study we saw short-term high potency statin treatment had a beneficial impact on frequency domain HRV measures suggestive of an impact on sympatho-activation. We found no effect on time domain HRV indices. This may suggest a lesser or no effect on parasympathetic tone.     

复方丹参滴丸对应急作训战士心率变异的影响

目的 :观察复方丹参滴丸对应急作训战士心率变异的影响 ,评价复方丹参滴丸对应急作训战士心肌保护作用。方法 :被试者为 60名新入伍 18岁～ 2 2岁战士 ,随机分为复方丹参滴丸组 (服用复方丹参滴丸每次 10丸 ,每日 3次 ,共 7d)、对照组 (服用安慰剂 )。采用Holter记录作训前 10min、作训中 3 0min及作训后 2 0min的心电信号 ,进行心率变异 (HRV)分析。结果 :两组战士在作训中LF均升高 ,HF下降 ,LF/HF升高 ,对照组较复方丹参滴丸组LF升高更显著 (P <0 .0 5 )。结论 :复方丹参滴丸可提高战士应急作训时的心率变异性 ,对应急作训战士心肌有保护作用。     

Abnormal Heart Rate Variability and Subtle Atrial Arrhythmia in Patients with Familial Amyloidotic Polyneuropathy

Background : Cardiac autonomic dysfunction is a common complication of familial amyloidotic polyneuropathy (FAP), but cardiac arrhythmia and conduction disturbances are also common. We analyzed heart rate variability (HRV) in FAP patients using power spectrum analysis and Poincaré plot analysis. Methods : HRV was analyzed in 24‐hour ECG recordings (Holter) in 41 FAP patients. Results : Power spectrum analysis showed reduced HRV in 21 FAP patients. A novel finding was that nine other patients with abnormal Poincaré plots had either very high power in the high‐frequency region (0.15–0.50 Hz) or broadband HRV power spectra without any distinctive spectral peaks. Reanalysis of their ECGs showed a previously undetected intermittent atrial arrhythmia. Conclusions : Subtle arrhythmias may be difficult to detect during analyses of Holter recordings. Patients with intermittent atrial arrhythmia were identified by broadband HRV spectra and abnormal Poincaré plots. High high‐frequency power in HRV and irregular heart rate patterns may indicate the presence of subtle atrial arrhythmia. Consequently, such patients should be excluded from studies of cardiac autonomic modulation.     

Heart Rate Variability in Heart Failure

The autonomic nervous system has an important role in the development and progression of the heart failure syndrome. Increased sympathetic, reduced parasympathetic, and impaired baroreceptor activity are well-documented features of heart failure. The analysis of heart rate variability can give insight into these autonomic abnormalities. A number of techniques now exist for assessing heart rate variability, and in general they reflect the known autonomic abnormalities. Power spectral analysis of RR variability has been claimed to reflect sympathovagal balance, but the reduced or absent low-frequency component in heart failure is paradoxical. It is likely that the absent low-frequency component in heart failure reflects impaired baroreceptor function. Although these various techniques of heart rate variability may be useful, reliability and reproducibility are problematic in this area. Better, more refined techniques for the noninvasive assessment of autonomic and baroreceptor function are still needed.     

Interaction between Heart Rate and Heart Rate Variability

Heart rate variability (HRV) is significantly associated with average heart rate (HR), therefore, HRV actually provides information on two quantities, that is, on HR and its variability. It is difficult to conclude which of these two plays a principal role in the HRV clinical value, or in other words, what is the HR contribution to the clinical significance of HRV. Moreover, the association between HRV and HR is both a physiological phenomenon and a mathematical one. The physiological HRV dependence on HR is determined by the autonomic nervous system activity, but the mathematical one is caused by the nonlinear relationship between RR interval and HR. By employing modification methods of the HRV and HR relationship, it is possible to investigate the HR contribution to the HRV clinical value. Recent studies have shown that the removal of the HR impact on HRV makes HRV more predictive for noncardiac death, however, the enhancement of this impact causes HRV to be a better predictor of cardiovascular mortality. Thus, HR seems to constitute a cardiovascular factor of the HRV predictive ability. HR also influences the reproducibility of HRV, therefore, HR changes should be considered when one compares HRV measurements in a given patient. This review summarizes methodological aspects of investigations of the HRV and HR interaction as well as latest observations concerning its clinical utility. The issues discussed in this article should also refer to any other heart rate dynamics analysis which indices are significantly associated with HR.