Kunz Vandeni C, Souza Raquel B, Takahashi Anielle C M, Catai Aparecida M, Silva Ester
Laboratory of Cardiovascular Physical Therapy, Nucleus of Research in Physical Exercise, Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Rev Bras Fisioter. 2011 Nov-Dec;15(6):503-10. doi: 10.1590/s1413-35552011005000020. Epub 2011 Oct 14.
A reduction in heart rate variability (HRV) is considered an important indicator of autonomic dysfunction.
The aims of this study were to evaluate the presence of autonomic dysfunction measured by HRV in patients with coronary artery disease (CAD) and to compare them with normal subjects.
A sample of 52 men (mean age 54±5.39 years) was allocated into three groups: obstructive CAD ≥50% (CAD+ n=18), obstructive CAD <50%, (CAD- n=17) and apparently healthy controls (CG n=17). Heart rate (HR) was measured at rest using a Polar®S810i for 15 min. HRV was analyzed via Shannon entropy (SE) and symbolic analysis (0V and 2ULV), which relate to sympathetic and vagal predominance, respectively. Statistical analysis included the Kruskal-Wallis test and multivariate analysis (p<0.05).
The CAD+ group presented lower SE and 2ULV% values and higher 0V% compared to CAD- and control groups (p<0.05). In the multivariate analysis, the presence of the clinical characteristics such as myocardial infarction and revascularization in the CAD+ group lead to a lower SE and higher 0V compared to the CAD- group. The use of angiotensin converting enzymes led to a higher SE in the CAD- group compared to the CAD+ (p<0.05).
In uncomplicated CAD+ patients the patterns of HRV have a lower complexity, a greater sympathetic modulation and a lower parasympathetic modulation compared to CAD- and control groups in supine resting conditions. These results indicate that autonomic heart dysfunction is related to the degree of coronary occlusion and cardiac compromise.
心率变异性（HRV）降低被认为是自主神经功能障碍的重要指标。
本研究旨在评估冠心病（CAD）患者中通过HRV测量的自主神经功能障碍情况，并将其与正常受试者进行比较。
选取52名男性（平均年龄54±5.39岁）样本，分为三组：阻塞性CAD≥50%（CAD+组，n = 18）、阻塞性CAD<50%（CAD-组，n = 17）和明显健康对照组（CG组，n = 17）。使用Polar®S810i在静息状态下测量心率（HR）15分钟。通过香农熵（SE）和符号分析（0V和2ULV）分析HRV，分别与交感神经和迷走神经优势相关。统计分析包括Kruskal-Wallis检验和多变量分析（p<0.05）。
与CAD-组和对照组相比，CAD+组的SE和2ULV%值较低，0V%较高（p<0.05）。在多变量分析中，与CAD-组相比，CAD+组中存在心肌梗死和血运重建等临床特征导致SE较低，0V较高。与CAD+组相比，CAD-组使用血管紧张素转换酶导致SE较高（p<0.05）。
在仰卧静息状态下，与CAD-组和对照组相比，单纯CAD+患者的HRV模式复杂性较低，交感神经调节更强，副交感神经调节更低。这些结果表明自主神经心脏功能障碍与冠状动脉阻塞程度和心脏损害有关。
