Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
J Am Soc Echocardiogr. 2010 Jul;23(7):762-5. doi: 10.1016/j.echo.2010.04.007. Epub 2010 May 15.
The relation between left ventricular filing velocities determined by Doppler echocardiography and autonomic nervous system function assessed by heart rate variability (HRV) is unclear. The aim of this study was to evaluate the influence of the autonomic nervous system assessed by the time and frequency domain indices of HRV in the Doppler indices of left ventricular diastolic filling velocities in patients without heart disease.
We studied 451 healthy individuals (255 female [56.4%]) with normal blood pressure, electrocardiogram, chest x-ray, and treadmill electrocardiographic exercise stress test results, with a mean age of 43+/-12 (range 15-82) years, who underwent transthoracic Doppler echocardiography and 24-hour electrocardiographic ambulatory monitoring. We studied indices of HRV on time (standard deviation [SD] of all normal sinus RR intervals during 24 hours, SD of averaged normal sinus RR intervals for all 5-minute segments, mean of the SD of all normal sinus RR intervals for all 5-minute segments, root-mean-square of the successive normal sinus RR interval difference, and percentage of successive normal sinus RR intervals>50 ms) and frequency (low frequency, high frequency, very low frequency, low frequency/high frequency ratio) domains relative to peak flow velocity during rapid passive filling phase (E), atrial contraction (A), E/A ratio, E-wave deceleration time, and isovolumic relaxation time. Statistical analysis was performed with Pearson correlation and logistic regression.
Peak flow velocity during rapid passive filling phase (E) and atrial contraction (A), E/A ratio, and deceleration time of early mitral inflow did not demonstrate a significant correlation with indices of HRV in time and frequency domain. We found that the E/A ratio was<1 in 45 individuals (10%). Individuals with an E/A ratio<1 had lower indices of HRV in frequency domain (except low frequency/high frequency) and lower indices of the mean of the SD of all normal sinus RR intervals for all 5-minute segments, root-mean-square of the successive normal sinus RR interval difference, and percentage of successive normal sinus RR intervals>50 ms in time domain. Logistic regression demonstrated that an E/A ratio<1 was associated with lower HF.
Individuals with no evidence of heart disease and an E/A ratio<1 demonstrated a significant decrease in indexes of HRV associated with parasympathetic modulation.
多普勒超声心动图测定的左心室充盈速度与心率变异性（HRV）评估的自主神经系统功能之间的关系尚不清楚。本研究旨在评估自主神经系统通过 HRV 的时域和频域指标对无心脏病患者左心室舒张充盈速度多普勒指数的影响。
我们研究了 451 名血压、心电图、胸部 X 线和跑步机心电图运动应激试验正常的健康个体（255 名女性[56.4%]），平均年龄 43+/-12（范围 15-82）岁，接受经胸多普勒超声心动图和 24 小时动态心电图监测。我们研究了 HRV 的时域（24 小时内所有窦性 RR 间期的标准差、所有 5 分钟段平均窦性 RR 间期的标准差、所有 5 分钟段窦性 RR 间期标准差的平均值、连续窦性 RR 间期差值的均方根和连续窦性 RR 间期>50ms 的百分比）和频域（低频、高频、极低频、低频/高频比）指标与快速被动充盈期（E）、心房收缩（A）、E/A 比值、E 波减速时间和等容舒张时间的峰值流速的关系。采用 Pearson 相关和逻辑回归进行统计学分析。
快速被动充盈期（E）和心房收缩（A）、E/A 比值和早期二尖瓣流入减速时间与 HRV 的时域和频域指标无显著相关性。我们发现，45 名个体（10%）的 E/A 比值<1。E/A 比值<1 的个体频域 HRV 指数较低（除低频/高频比外），时域的平均窦性 RR 间期标准差各 5 分钟段、连续窦性 RR 间期差值的均方根和连续窦性 RR 间期>50ms 的百分比也较低。逻辑回归显示，E/A 比值<1 与较低的 HF 相关。
无心脏病证据且 E/A 比值<1 的个体，与副交感神经调节相关的 HRV 指数显著降低。
