Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada.
Can J Cardiol. 2010 Jun-Jul;26(6):303-12. doi: 10.1016/s0828-282x(10)70395-0.
Heart rate variability (HRV) is a noninvasive, practical and reproducible measure of autonomic nervous system function. A heart rate that is variable and responsive to demands is believed to bestow a survival advantage, whereas reduced HRV may be associated with poorer cardiovascular health and outcomes. In recent years, many researchers have investigated the prognostic implications of HRV in a variety of clinical populations. Evidence suggests that reduced HRV has prognostic significance for individuals with myocardial infarction, chronic heart failure, unstable angina and diabetes mellitus. Interventions to increase HRV, such as exercise therapy, have also been examined. The findings of the present review suggest that exercise therapy may improve HRV in myocardial infarction, chronic heart failure and revascularization patients by increasing vagal tone and decreasing sympathetic activity. One hypothesis is that a shift toward greater vagal modulation may positively affect the prognosis of these individuals. While the underlying mechanisms by which exercise training improves vagal modulation are speculative at present, angiotensin II and nitric oxide may be potential mediators.
心率变异性（HRV）是一种非侵入性、实用且可重复的自主神经系统功能测量方法。人们认为，能够根据需求变化且响应迅速的心率能够带来生存优势，而 HRV 降低可能与心血管健康状况较差和预后不良有关。近年来，许多研究人员已经在各种临床人群中研究了 HRV 的预后意义。有证据表明，HRV 降低对心肌梗死、慢性心力衰竭、不稳定型心绞痛和糖尿病患者具有预后意义。已经研究了增加 HRV 的干预措施，例如运动疗法。本综述的研究结果表明，运动疗法可以通过增加迷走神经张力和降低交感神经活动来改善心肌梗死、慢性心力衰竭和血运重建患者的 HRV。一种假设是，向更大的迷走神经调节转变可能会对这些患者的预后产生积极影响。虽然目前运动训练改善迷走神经调节的潜在机制仍在推测之中，但血管紧张素 II 和一氧化氮可能是潜在的介质。
