Carnethon Mercedes R, Liao Duanping, Evans Gregory W, Cascio Wayne E, Chambless Lloyd E, Heiss Gerardo
Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, CA, USA.
Am Heart J. 2002 May;143(5):808-13. doi: 10.1067/mhj.2002.121928.
The heart rate variability (HRV) response to postural change is a sensitive measure of the shift in autonomic balance from parasympathetic to sympathetic predominance that, when attenuated or absent, has been correlated with prevalent disease in patient populations. In a healthy population sample, we evaluated whether the shift in HRV with postural change differed by demographic characteristics as well as whether it differed between participants with established coronary heart disease (CHD) risk factors and their counterparts.
HRV was measured for 2 minutes in the supine and standing positions in a biracial sample of men and women (aged 45-64 years) without clinical CHD from the Atherosclerosis Risk In Communities Study (n = 7686). Mean differences among supine and standing mean R-R interval lengths, the SD of R-R intervals, and high-frequency power (HF) were compared by demographic characteristics (age, race, and sex) and CHD risk factors (smoking, obesity, physical activity, hypertension, and diabetes). Multivariable linear regression models were used to adjust for demographic characteristics.
Smaller changes in R-R intervals and larger changes in SD of R-R intervals with standing were found among participants who were obese, less physically active than their counterparts, hypertensive, and diabetic. Smaller changes in HF were identified in male and white participants, but there were no differences in HF by CHD risk factors once models were adjusted for demographic characteristics.
These simple noninvasive measures can be used to detect differences in cardiac autonomic balance that may be markers for autonomic impairment in healthy adults.
心率变异性(HRV)对体位变化的反应是自主神经平衡从副交感神经占主导转变为交感神经占主导的敏感指标,当这种反应减弱或消失时,与患者群体中的常见疾病相关。在一个健康人群样本中,我们评估了HRV随体位变化的改变是否因人口统计学特征而异,以及在有既定冠心病(CHD)危险因素的参与者与其对应者之间是否存在差异。
在社区动脉粥样硬化风险研究中,对无临床CHD的45至64岁男女双种族样本(n = 7686)在仰卧位和站立位测量2分钟的HRV。通过人口统计学特征(年龄、种族和性别)和CHD危险因素(吸烟、肥胖、身体活动、高血压和糖尿病)比较仰卧位和站立位平均R-R间期长度、R-R间期标准差和高频功率(HF)的平均差异。使用多变量线性回归模型调整人口统计学特征。
在肥胖、身体活动比其对应者少、患有高血压和糖尿病的参与者中,站立时R-R间期变化较小,R-R间期标准差变化较大。在男性和白人参与者中发现HF变化较小,但在模型调整人口统计学特征后,CHD危险因素对HF没有差异。
这些简单的非侵入性测量方法可用于检测心脏自主神经平衡的差异,这些差异可能是健康成年人自主神经损伤的标志物。