Guzzetti S, Mezzetti S, Magatelli R, Porta A, De Angelis G, Rovelli G, Malliani A
Centro Ricerche Cardiovascolari, CNR, Dipartimento Scienze Precliniche L.I.T.A. Vialba, Medicina Interna II, Ospedale L. Sacco, Universita degli Studi, Via GB Grassi 74, 20157 Milan, Italy.
Auton Neurosci. 2000 Dec 28;86(1-2):114-9. doi: 10.1016/S1566-0702(00)00239-3.
It has recently been demonstrated that SDNN of heart rate variability (HRV) is a useful independent prognostic tool in chronic heart failure (CHF). The purpose of the present study was to evaluate if spectral and non-linear analysis of 24-h HRV, considered markers of autonomic cardiac modulation, contain independent prognostic information in CHF patients. Twenty normal subjects and thirty consecutive outpatients with clinically stable CHF were studied for 2 years. Periods of 300 R-R intervals were analyzed from Holter recordings. The power spectral analysis, the slope of the linear relationship between log-power versus log-frequency (1/f), and the complexity content (using corrected conditional entropy; CCE) of the R-R series were calculated. The normalized power of the low frequency spectral component (LF) and the 1/f slope were significantly lower in patients compared to controls (respectively 30.1 +/- 3.0 vs. 48.6 +/- 3.4 and -1.27 +/- 0.04 vs. -1.08 +/- 0.05; P < 0.05). Moreover, the patients who died during the study presented a reduced LF (20.9 +/- 4.1 vs. 35.5 +/- 3.5 nu; P < 0.05) and a steeper 1/f slope (-1.40 +/- 0.09 vs. -1.21 +/- 0.04 nuts, P < 0.05) compared to survivors. These results remained significant in a logistic model including heart rate and SDNN. The information content present in spectral and non-linear analysis of HRV in CHF patients has prognostic relevance independently from the time domain measures of HRV. In particular, the reduction of LF power seems the best indicator among those considered.
最近有研究表明，心率变异性（HRV）的标准差（SDNN）是慢性心力衰竭（CHF）中一种有用的独立预后工具。本研究的目的是评估24小时HRV的频谱和非线性分析（被视为自主心脏调节的标志物）是否包含CHF患者的独立预后信息。对20名正常受试者和30名临床稳定的CHF门诊患者进行了为期2年的研究。从动态心电图记录中分析300个R-R间期。计算了功率谱分析、对数功率与对数频率之间线性关系的斜率（1/f）以及R-R序列的复杂度（使用校正条件熵；CCE）。与对照组相比，患者的低频频谱成分（LF）归一化功率和1/f斜率显著降低（分别为30.1±3.0对48.6±3.4以及-1.27±0.04对-1.08±0.05；P<0.05）。此外，与幸存者相比，在研究期间死亡的患者LF降低（20.9±4.1对35.5±3.5 nu；P<0.05）且1/f斜率更陡（-1.40±0.09对-1.21±0.04 nuts，P<0.05）。在包含心率和SDNN的逻辑模型中，这些结果仍然显著。CHF患者HRV频谱和非线性分析中存在的信息内容与HRV的时域测量无关，具有预后相关性。特别是，LF功率降低似乎是所考虑指标中最好的指标。
