Goldberger Jeffrey J, Le Francis Kiet, Lahiri Marc, Kannankeril Prince J, Ng Jason, Kadish Alan H
Division of Cardiac Electrophysiology, Northwestern University Feinberg School of Medicine, 251 E. Huron, Feinberg Pavilion 8-542, Chicago, IL 60611, USA.
Am J Physiol Heart Circ Physiol. 2006 Jun;290(6):H2446-52. doi: 10.1152/ajpheart.01118.2005. Epub 2006 Jan 13.
The objective of this study was to evaluate whether heart rate variability (HRV) can be used as an index of parasympathetic reactivation after exercise. Heart rate recovery after exercise has recently been shown to have prognostic significance and has been postulated to be related to abnormal recovery of parasympathetic tone. Ten normal subjects [5 men and 5 women; age 33 +/- 5 yr (mean +/- SE)] exercised to their maximum capacity, and 12 subjects (10 men and 2 women; age 61 +/- 10 yr) with coronary artery disease exercised for 16 min on two separate occasions, once in the absence of atropine and once with atropine (0.04 mg/kg) administered during exercise. The root mean square residual (RMS), which measures the deviation of the R-R intervals from a straight line, as well as the standard deviation (SD) and the root mean square successive difference of the R-R intervals (MSSD), were measured on successive 15-, 30-, and 60-s segments of a 5-min ECG obtained immediately after exercise. In recovery, the R-R interval was shorter with atropine (P < 0.0001). Without atropine, HRV, as measured by the MSSD and RMS, increased early in recovery from 4.1 +/- 0.4 and 3.7 +/- 0.4 ms in the first 15 s to 7.2 +/- 1.0 and 7.4 +/- 0.9 ms after 1 min, respectively (P < 0.0001). RMS (range 1.7-2.1 ms) and MSSD were less with atropine (P < 0.0001). RMS remained flat throughout recovery, whereas MSSD showed some decline over time from 3.0 to 2.2 ms (P < 0.002). RMS and MSSD were both directly related (r(2) = 0.47 and 0.56, respectively; P < 0.0001) to parasympathetic effect, defined as the difference in R-R interval without and with atropine. In conclusion, RMS and MSSD are parameters of HRV that can be used in the postexercise recovery period as indexes of parasympathetic reactivation after exercise. These tools may improve our understanding of parasympathetic reactivation after exercise and the prognostic significance of heart rate recovery.
本研究的目的是评估心率变异性（HRV）是否可作为运动后副交感神经再激活的指标。最近研究表明，运动后的心率恢复具有预后意义，并推测其与副交感神经张力的异常恢复有关。10名正常受试者（5名男性和5名女性；年龄33±5岁（均值±标准误））进行最大量运动，12名冠状动脉疾病患者（10名男性和2名女性；年龄61±10岁）分两次进行16分钟运动，一次在无阿托品情况下，另一次在运动期间给予阿托品（0.04mg/kg）。在运动后立即获取的5分钟心电图的连续15秒、30秒和60秒时段上，测量均方根残差（RMS）（其测量R-R间期与直线的偏差）以及R-R间期的标准差（SD）和逐差均方根（MSSD）。在恢复过程中，使用阿托品时R-R间期较短（P<0.0001）。在无阿托品情况下，以MSSD和RMS测量的HRV在恢复早期增加，从最初15秒时的4.1±0.4和3.7±0.4毫秒分别增至1分钟后的7.2±1.0和7.4±0.9毫秒（P<0.0001）。使用阿托品时RMS（范围1.7 - 2.1毫秒）和MSSD较小（P<0.0001）。RMS在整个恢复过程中保持平稳，而MSSD随时间从3.0毫秒降至2.2毫秒（P<0.002）。RMS和MSSD均与副交感神经效应直接相关（r²分别为0.47和0.56；P<0.0001），副交感神经效应定义为无阿托品和有阿托品时R-R间期的差值。总之，RMS和MSSD是HRV的参数，可在运动后恢复期用作运动后副交感神经再激活的指标。这些工具可能会增进我们对运动后副交感神经再激活以及心率恢复的预后意义的理解。
