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[体育锻炼对心率变异性的影响]

[The influence of physical exercise on heart rate variability].

作者信息

Gajek Jacek, Zyśko Dorota, Negrusz-Kawecka Marta, Halawa Bogumił

机构信息

Katedra i Klinika Kardiologii Akademii Medycznej we Wrocławiu.

出版信息

Pol Merkur Lekarski. 2003 Mar;14(81):202-4.

Abstract

Heart rate variability is controlled by the influence of autonomic nervous system, whereas one part of the system modulates the activity of the other. There is evidence of increased sympathetic activity in patients (pts) with essential hypertension. The aim of the study was to assess the persisting influence of increased sympathetic activity 30 min after moderate physical exercise on heart rate variability in patients with arterial hypertension. The study was performed in 19 patients (10 women, mean age 52.7 +/- 9.5 years and 9 men, mean age 37.7 +/- 8.8 years) with stage I (6 pts) and stage II (13 pts) arterial hypertension. All studied pts had sinus rhythm, were free of diabetes, coronary heart disease and congestive heart failure. 24-hour Holter monitoring was performed and for 30 min before the exercise test the pts stayed in supine rest. The exercise tests were performed between 10 and 11 a.m. Immediately after the exercise all pts stayed in supine position for 30 min. The heart rate variability parameters were studied using Holter monitoring system Medilog Optima Jet and were then analysed statistically. The mean energy expenditure during the exercise was 5.8 +/- 1.1 METs and the maximal heart rate was 148.1 +/- 20.3 bpm. All studied HRV parameters were significantly different in the assessed time period compared to the baseline values (p < 0.001). Significant correlation was found between the age of the studied patients and the mean RR interval, what can be considered as a hyperkinetic (hyperadrenergic) circulatory status and shorter RR interval in younger pts. Significant negative correlation between the age and SDNN parameter (r = -0.65, p < 0.001), 30 min after the exercise mirrors the prolonged adrenergic influence in older pts. The present study shows that the influence of moderate physical exercise on heart rate variability in pts with essential hypertension is extended over 30 min period after exercise and is more pronounced in older pts. The studies on HRV should be performed at longer time intervals after exercise.

摘要

心率变异性受自主神经系统的影响,而该系统的一部分会调节另一部分的活动。有证据表明原发性高血压患者的交感神经活动增强。本研究的目的是评估中度体育锻炼30分钟后交感神经活动增强对动脉高血压患者心率变异性的持续影响。该研究在19例患者中进行(10名女性,平均年龄52.7±9.5岁,9名男性,平均年龄37.7±8.8岁),患有I期(6例)和II期(13例)动脉高血压。所有研究患者均为窦性心律,无糖尿病、冠心病和充血性心力衰竭。进行了24小时动态心电图监测,在运动试验前30分钟患者仰卧休息。运动试验在上午10点至11点之间进行。运动后所有患者立即仰卧30分钟。使用动态心电图监测系统Medilog Optima Jet研究心率变异性参数,然后进行统计分析。运动期间的平均能量消耗为5.8±1.1梅脱,最大心率为148.1±20.3次/分钟。与基线值相比,所有研究的心率变异性参数在评估时间段内均有显著差异(p<0.001)。研究患者的年龄与平均RR间期之间存在显著相关性,这可被视为一种高动力(高肾上腺素能)循环状态,且年轻患者的RR间期较短。运动后30分钟,年龄与SDNN参数之间存在显著负相关(r=-0.65,p<0.001),这反映了老年患者肾上腺素能影响的延长。本研究表明,中度体育锻炼对原发性高血压患者心率变异性的影响在运动后30分钟内持续存在,且在老年患者中更为明显。心率变异性研究应在运动后更长的时间间隔进行。

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