Zdrenghea D, Sitar-Tăut Adela, Pop Dana
Department of Cardiology, Rehabilitation Hospital, Cluj-Napoca, Romania.
Rom J Intern Med. 2007;45(2):171-5.
Both heart variability (HRV) and heart rate recovery (HRR) after exercise are considered to reflect the sympathetic-vagal balance and low values of them have negative prognostic significance, especially in ischemic patients. The main goal of the research was to establish if there is a correlation between HRR and HRV in ischemic patients and if interchangeability between them is possible. There were studied 63 patients with ischemic heart disease: old myocardial infarction, stable angina. unstable angina and silent ischemia. All patients performed exercise stress testing, the heart rate recovery being calculated as the difference between peak heart rate and the rate determined at one minute after the exercise was stopped. The "time-domain" HRV parameters SDANN, SDNN, RMSSD were automatically calculated during a 24 hours Holter ECG monitoring. The mean values were HRR: 39.24 +/- 17.47 beats/min (abnormal in 6% of the patients); HRV: SDNN-112.75 +/- 37.87 msec, SDANN-103.02 +/- 33.25 msec, RMSSD-50.21 +/- 48.15 msec (low HRV in 68.3% of the patients). There was no significant correlation between HRR and HRV's parameters (p > 0.05). There was no significant difference between HRR's mean in subjects with normal or abnormal values of HRV parameters (p > 0.05). Thus, in our study, the HRV values cannot be predicted by the determination of HRR, HRV parameters being more sensible than HRR to reveal increased sympathetic drive.
运动后的心率变异性(HRV)和心率恢复(HRR)均被认为可反映交感 - 迷走神经平衡,其低值具有负面预后意义,尤其是在缺血性患者中。该研究的主要目的是确定缺血性患者的HRR与HRV之间是否存在相关性,以及它们之间是否具有互换性。研究了63例缺血性心脏病患者:陈旧性心肌梗死、稳定型心绞痛、不稳定型心绞痛和无症状性心肌缺血。所有患者均进行了运动负荷试验,心率恢复计算为运动峰值心率与运动停止后1分钟时测定的心率之差。在24小时动态心电图监测期间自动计算“时域”HRV参数SDANN、SDNN、RMSSD。平均值为:HRR:39.24±17.47次/分钟(6%的患者异常);HRV:SDNN - 112.75±37.87毫秒,SDANN - 103.02±33.25毫秒,RMSSD - 50.21±48.15毫秒(68.3%的患者HRV低)。HRR与HRV参数之间无显著相关性(p>0.05)。HRV参数值正常或异常的受试者的HRR平均值之间无显著差异(p>0.05)。因此,在我们的研究中,HRR的测定无法预测HRV值,HRV参数在揭示交感神经驱动增加方面比HRR更敏感。