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一项针对健康老年人心率及心率变异性的15年纵向随访研究。

A 15-year longitudinal follow-up study of heart rate and heart rate variability in healthy elderly persons.

作者信息

Tasaki H, Serita T, Irita A, Hano O, Iliev I, Ueyama C, Kitano K, Seto S, Hayano M, Yano K

机构信息

The Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.

出版信息

J Gerontol A Biol Sci Med Sci. 2000 Dec;55(12):M744-9. doi: 10.1093/gerona/55.12.m744.

Abstract

BACKGROUND

Few researchers have conducted heart rate (HR) studies in healthy very elderly subjects aged 70 years or older, and there are no longitudinal follow-up studies in this population. The objective of this study was to evaluate long-term changes in HR and heart rate variability (HRV) with aging in healthy elderly persons by means of comparison between two Holter monitor recordings obtained at an interval of 15 years.

METHODS

The study population consisted of 15 healthy elderly persons (10 women and 5 men) aged 64 to 80 years (mean 70 +/- 4.1) at the first recording, and 79 to 95 years old (mean 85 +/- 4.1 years) at the second recording 15 years later. Nighttime (midnight to 5 AM) and daytime (noon to 5 PM) HR and HRV were obtained, and paired t tests were performed to assess the differences in each parameter of nighttime and daytime HR and HRV between the two (15-year interval) Holter monitor recordings.

RESULTS

The results of the t-test comparisons were as follows: there was a significant increase in minimal, maximal, and average HRs (nighttime, p < .01; daytime, p < .05, respectively). On the other hand, with regard to HRV, there was a significant nighttime decrease in the SDNN index (mean of standard deviations of normal RR intervals between adjacent QRS complexes resulting from sinus node depolarizations for all 5-minute segments) (p = .0086), and a significant daytime increase in the NN50 (number of adjacent normal RR intervals >50 milliseconds) per hour (p = .0425). Moreover, there was a significant decrease in the low-frequency (LF) component (nighttime, p = .0151; daytime, p = .0032), and a significant decrease in the LF/HF ratio (nighttime, p = .0270; daytime, p = .0371), but there was no significant change in the nighttime or daytime high-frequency (HF) component.

CONCLUSIONS

HR increased with age over the 15-year period in the healthy elderly persons. As for concurrent changes in HRV, however, the parameters of sympathetic modulation decreased, and the parameters of parasympathetic modulation were unchanged or slightly increased.

摘要

背景

很少有研究人员对70岁及以上的健康高龄受试者进行心率(HR)研究,且该人群中尚无纵向随访研究。本研究的目的是通过比较间隔15年获得的两份动态心电图记录,评估健康老年人HR和心率变异性(HRV)随年龄的长期变化。

方法

研究人群包括15名健康老年人(10名女性和5名男性),首次记录时年龄为64至80岁(平均70±4.1岁),15年后第二次记录时年龄为79至95岁(平均85±4.1岁)。获取夜间(午夜至凌晨5点)和白天(中午至下午5点)的HR和HRV,并进行配对t检验,以评估两份(间隔15年)动态心电图记录之间夜间和白天HR及HRV各参数的差异。

结果

t检验比较结果如下:最低、最高和平均HR显著增加(夜间,p<.01;白天,p<.05)。另一方面,关于HRV,SDNN指数(所有5分钟时段内由窦房结去极化导致的相邻QRS波群之间正常RR间期标准差的平均值)夜间显著降低(p = .0086),每小时NN50(相邻正常RR间期>50毫秒的数量)白天显著增加(p = .0425)。此外,低频(LF)成分显著降低(夜间,p = .0151;白天,p = .0032),LF/HF比值显著降低(夜间,p = .0270;白天,p = .0371),但夜间或白天高频(HF)成分无显著变化。

结论

在15年期间,健康老年人的HR随年龄增加。然而,关于HRV的同时变化,交感神经调制参数降低,副交感神经调制参数未改变或略有增加。

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