心脏迷走神经调制评估方法的比较。

Comparison of assessment methods of cardiac vagal modulation.

机构信息

Faculdade de Ciências Médicas e da Saúde de Juiz de Fora, Juiz de Fora, MG, Brazil.

出版信息

Arq Bras Cardiol. 2011 Dec;97(6):493-501. doi: 10.1590/s0066-782x2011005000109. Epub 2011 Oct 21.

DOI:10.1590/s0066-782x2011005000109

PMID:22011809

Abstract

BACKGROUND

Several methods have been used to assess cardiac vagal modulation, but there are gaps regarding the association and accuracy of these methods.

OBJECTIVE

To investigate the association between three valid, reproducible and commonly methods used to assess cardiac vagal modulation and compare their accuracies.

METHODS

Thirty healthy men (23 ± 4 years) and 15 men with coronary artery disease (61 ± 10 years) were evaluated in counterbalanced design by Heart Rate Variability (HRV; variables: the time domain = pNN50, SDNN and RMSSD, the frequency domain HF = ms² and HF n.u.), Respiratory Sinus Arrhythmia (RSA) and 4-second Exercise Test (T4s). Thirty healthy men (23 ± 4 years) and 15 men with coronary artery disease (61 ± 10 years) were evaluated in counterbalanced order by Heart Rate Variability (HRV; variables: the time domain = pNN50, SDNN and RMSSD, the frequency domain HF = ms² and HF n.u.), Respiratory Sinus Arrhythmia (RSA) and 4-second Exercise Test (T4s).

RESULTS

Healthy subjects had higher vagal modulation by the three methods (p <0.05). There was a correlation in the healthy group (p <0.05) between the results of HRV (SDNN and pNN50 and RSA, but there was no correlation between the T4s and the other two methods. In the group with coronary artery disease, there was a correlation between the results of HRV (pNN50, SDNN, RMSSD, HF ms² and HF n.u.) and RSA. In addition, there was a correlation between the RSA and T4s. Finally, the T4s and RSA methods presented more accurate effect size and better accuracy (p <0.05), when compared to the HRV.

CONCLUSION

HRV and RSA generated partially redundant results in healthy subjects and in patients with coronary artery disease, while the T4s generated results that were complementary to HRV and RSA in healthy subjects. In addition, RSA and T4s methods were more accurate when discriminating cardiac vagal modulation between healthy subjects and patients with coronary artery disease, when compared to HRV.

摘要

背景

有几种方法已被用于评估心脏迷走神经调节，但这些方法的关联和准确性仍存在差距。

目的

研究三种有效、可重复且常用的评估心脏迷走神经调节方法之间的相关性，并比较它们的准确性。

方法

在对照设计中，对 30 名健康男性（23 ± 4 岁）和 15 名冠状动脉疾病男性（61 ± 10 岁）进行心率变异性（HRV；变量：时域 = pNN50、SDNN 和 RMSSD，频域 = HF = ms² 和 HF n.u.）、呼吸窦性心律失常（RSA）和 4 秒运动试验（T4s）评估。在对照设计中，对 30 名健康男性（23 ± 4 岁）和 15 名冠状动脉疾病男性（61 ± 10 岁）进行心率变异性（HRV；变量：时域 = pNN50、SDNN 和 RMSSD，频域 = HF = ms² 和 HF n.u.）、呼吸窦性心律失常（RSA）和 4 秒运动试验（T4s）评估。

结果

健康受试者的三种方法的迷走神经调节能力均较高（p <0.05）。在健康组中，HRV（SDNN 和 pNN50 与 RSA）的结果之间存在相关性（p <0.05），但 T4s 与其他两种方法之间无相关性。在冠状动脉疾病组中，HRV（pNN50、SDNN、RMSSD、HF ms² 和 HF n.u.）和 RSA 的结果之间存在相关性。此外，RSA 和 T4s 之间存在相关性。最后，与 HRV 相比，T4s 和 RSA 方法具有更大的效应量和更好的准确性（p <0.05）。