Gianaros Peter J, Salomon Kristen, Zhou Fan, Owens Jane F, Edmundowicz Daniel, Kuller Lewis H, Matthews Karen A
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Psychosom Med. 2005 Jul-Aug;67(4):553-60. doi: 10.1097/01.psy.0000170335.92770.7a.
Reduced cardiac parasympathetic activity, as indicated by a reduced level of clinic or ambulatory high-frequency heart rate variability (HF-HRV), is associated with an increased risk for atherosclerosis and coronary artery disease. We tested whether the reduction in HF-HRV to a psychological stressor relative to a baseline level is also associated with subclinical coronary or aortic atherosclerosis, as assessed by calcification in these vascular regions.
Spectral estimates of 0.15 to 0.40 Hz HF-HRV were obtained from 94 postmenopausal women (61-69 years) who engaged in a 3-minute speech-preparation stressor after a 6-minute resting baseline. A median of 282 days later, electron beam tomography (EBT) was used to measure the extent of coronary and aortic calcification.
In univariate analyses, a greater reduction in HF-HRV from baseline to speech preparation was associated with having more extensive calcification in the coronary arteries (rho = -0.29, p = .03) and in the aorta (rho = -0.22, p = .06). In multivariate analyses that controlled for age, education level, smoking status, hormone therapy use, fasting glucose, high-density lipoproteins, baseline HF-HRV, and the stressor-induced change in respiration rate, a greater stressor-induced reduction in HF-HRV was associated with more calcification in the coronary arteries (B = -1.21, p < .05), and it was marginally associated with more calcification in the aorta (B = -0.92, p = .09).
In postmenopausal women, a greater reduction in cardiac parasympathetic activity to a psychological stressor from baseline may be an independent correlate of subclinical atherosclerosis, particularly in the coronary arteries.
临床或动态高频心率变异性（HF-HRV）水平降低表明心脏副交感神经活动减弱，这与动脉粥样硬化和冠状动脉疾病风险增加有关。我们测试了相对于基线水平，HF-HRV因心理应激源而降低是否也与亚临床冠状动脉或主动脉粥样硬化有关，这些血管区域的钙化可对此进行评估。
从94名绝经后女性（61 - 69岁）中获取0.15至0.40赫兹HF-HRV的频谱估计值，她们在6分钟静息基线后进行3分钟的演讲准备应激任务。在中位数为282天后，使用电子束断层扫描（EBT）测量冠状动脉和主动脉钙化程度。
在单变量分析中，从基线到演讲准备阶段HF-HRV降低幅度越大，冠状动脉（rho = -0.29，p = .03）和主动脉（rho = -0.22，p = .06）钙化越广泛。在多变量分析中，控制了年龄、教育水平、吸烟状况、激素治疗使用情况、空腹血糖、高密度脂蛋白、基线HF-HRV以及应激源引起的呼吸频率变化后，应激源引起的HF-HRV更大幅度降低与冠状动脉更多钙化有关（B = -1.21，p < .05），与主动脉更多钙化存在边缘关联（B = -0.92，p = .09）。
在绝经后女性中，相对于基线，心脏副交感神经活动因心理应激源而更大幅度降低可能是亚临床动脉粥样硬化的独立相关因素，尤其是在冠状动脉中。
