Palova Sabina, Havlin Jan, Charvat Jiri
Department of Medicine, 2nd Medical Faculty, Charles University and Faculty Hospital Motol, Prague, Czech Republic.
Neuro Endocrinol Lett. 2012;33(2):196-200.
To evaluate the association of heart rate variability (HRV) examined in supine and standing position with ambulatory blood pressure monitoring (ABPM) in patients with anorexia nervosa (AN).
HRV in supine and standing position and ABPM were examined in 30 AN patients and 30 control subjects. The correlations between HRV and ABPM were evaluated.
The average age was 25±5 in AN patients and 25±4 years in controls (NS). LF (low frequency) power in AN patients and controls was comparable in supine position. LF power significantly increased during standing in controls, but no increment was detected in AN patients. The HF (high frequency) power was significantly increased in AN patients in supine position, but after standing was comparable with controls. The ratio LF/HF was lower both in supine and standing position in AN patients but the differences did not reach statistical significance. Blood pressure values in AN patients were comparable with controls in supine position but were significantly lower in standing position. Ambulatory blood pressure values were significantly lower in AN patients during active but not sleeping period. In standing position HF and LF powers positively and LF/HF negatively correlated with ABPM blood pressure values during active period in controls while in AN patients only LF power correlated with diastolic and mean blood pressures.
The lower ABPM values in AN patients during active period in comparison with control subjects may be explained by HRV changes, mainly by its impaired relations with blood pressure in standing position.
评估神经性厌食症(AN)患者仰卧位和站立位心率变异性(HRV)与动态血压监测(ABPM)之间的关联。
对30例AN患者和30例对照者进行仰卧位和站立位HRV以及ABPM检查。评估HRV与ABPM之间的相关性。
AN患者的平均年龄为25±5岁,对照者为25±4岁(无显著差异)。AN患者和对照者在仰卧位时的低频(LF)功率相当。对照者站立时LF功率显著增加,但AN患者未检测到增加。AN患者仰卧位时高频(HF)功率显著增加,但站立后与对照者相当。AN患者仰卧位和站立位时LF/HF比值均较低,但差异未达到统计学意义。AN患者仰卧位时血压值与对照者相当,但站立位时显著较低。AN患者动态血压值在活动期而非睡眠期显著较低。在站立位时,对照者活动期HF和LF功率与ABPM血压值呈正相关,LF/HF与ABPM血压值呈负相关,而在AN患者中只有LF功率与舒张压和平均血压相关。
与对照者相比,AN患者活动期较低的ABPM值可能由HRV变化所解释,主要是由于其在站立位时与血压的关系受损。