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[心率变异性参数的可重复性差]

[Poor reproducibility of parameters of heart rate variations].

作者信息

Breuer H W, Skyschally A, Wehr M, Schulz R, Heusch G

机构信息

Abteilung für Pathophysiologie, Universitätsklinikum Essen.

出版信息

Z Kardiol. 1992 Sep;81(9):475-81.

PMID:1279903
Abstract

The analysis of heart rate variability is supposed to be a marker of autonomic cardiac activity and is used for risk stratification of post-infarction patients. Analysis of heart rate variability in the frequency domain may permit a differentiation of vagal and sympathetic control; for such analyses only short time intervals characterized by a steady-state autonomic balance can be used. Yet, it is unclear whether single determinations of heart rate variability indices derived from short time intervals yield reproducible results. Therefore, the reproducibility of heart rate variability indices was studied with weekly measurements in 10 healthy volunteers under the following defined conditions: 13 min supine rest, 10 min standing, 13 min sitting, and 15 min cycle ergometry followed by a 14 min recovery period. Heart rate variability was determined in the frequency domain (fast Fourier transformation) and in the time domain. The reproducibility was estimated by the coefficient of variation (CV). Additionally, the reproducibility of heart rate, blood pressure, and the expiratory-inspiratory ratio of heart rate was determined. The reproducibility of the frequency domain indices (36.6-74.9% CV) and of the time domain indices (19.6-32.8% CV) was considerably worse than that of heart rate (5.2-8.2% CV), blood pressure (5.1-8.2% CV) and the expiratory-inspiratory ratio of heart rate (4.6% CV). The reproducibility of heart rate variability indices was not improved by orthostatic or ergometric challenge. This poor reproducibility does not permit a reliable interpretation of heart rate variability on the basis of single measurements in healthy volunteers. Given the wide range and scatter of the measured parameters, the diagnostic and prognostic value of heart rate variability indices derived from short recording periods appears questionable.

摘要

心率变异性分析被认为是自主心脏活动的一个标志物,并用于心肌梗死后患者的风险分层。在频域中分析心率变异性可能有助于区分迷走神经和交感神经的控制;对于此类分析,只能使用以稳态自主平衡为特征的短时间间隔。然而,尚不清楚从短时间间隔得出的心率变异性指标的单次测定是否能产生可重复的结果。因此,在以下规定条件下,对10名健康志愿者每周进行测量,研究心率变异性指标的可重复性:仰卧休息13分钟、站立10分钟、坐着13分钟、进行15分钟的踏车测力计运动,随后是14分钟的恢复期。在频域(快速傅里叶变换)和时域中测定心率变异性。通过变异系数(CV)估计可重复性。此外,还测定了心率、血压以及心率的呼气与吸气比值的可重复性。频域指标(CV为36.6 - 74.9%)和时域指标(CV为19.6 - 32.8%)的可重复性明显低于心率(CV为5.2 - 8.2%)、血压(CV为5.1 - 8.2%)和心率的呼气与吸气比值(CV为4.6%)。体位改变或测力计运动挑战并未改善心率变异性指标的可重复性。这种较差的可重复性使得无法基于健康志愿者的单次测量对心率变异性进行可靠解读。鉴于所测参数的范围广泛且分散,从短记录期得出的心率变异性指标的诊断和预后价值似乎值得怀疑。

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