Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, Minnesota.
Alcohol Clin Exp Res. 2014 Jan;38(1):9-26. doi: 10.1111/acer.12270. Epub 2013 Oct 11.
Heart rate variability (HRV) is an objective and sensitive measure of integrated physiological functioning reflective of heart rhythm responsivity to internal and external demands. Reduced HRV is associated with vulnerability to stress and deterioration of medical and/or psychiatric conditions, while increased HRV is associated with a favorable treatment response and recovery from various medical and/or psychiatric conditions. Our previous review found that acute alcohol consumption caused decreased parasympathetic and increased sympathetic HRV effects in both nonalcoholic and chronic alcohol users. This review investigates the effects of chronic alcohol consumption on HRV in alcohol-dependent subjects and nondependent users. MEDLINE, Scopus, and PubMed were searched for human experimental and clinical trials that measured the effects of chronic alcohol use on HRV. Only publications that included a description of their study designs and clearly stated methodologies for data collections, and outcome measures were reviewed. We have reviewed a total of 24 articles. In nondependent users, low dose (approximating the recommended daily amount of 1 standard drink in women and 2 in men) use is associated with increased HRV parameters compared to those who drink less frequently or abstain altogether. A further increase in consumption is associated with decreased HRV compared to both abstainers and more moderate drinkers. HRV changes during withdrawal generally follow the same negative direction but are more complex and less understood. In dependent subjects, an improvement in HRV was seen following abstinence but remained reduced compared to nonalcoholic controls. This review demonstrates that HRV changes associated with chronic use follow a J-shaped curve. It supports recommendations that limit daily alcohol intake to no more than 2 drinks for men and 1 drink for women. Future studies should investigate HRV as a biomarker of alcoholism development and treatment response as well as the physiological basis for alcohol effects on HRV.
心率变异性（HRV）是一种客观且敏感的综合生理功能测量方法，反映了心率对内部和外部需求的反应性。HRV 降低与对压力的脆弱性以及医疗和/或精神状况的恶化有关，而 HRV 增加与有利的治疗反应和从各种医疗和/或精神状况中恢复有关。我们之前的综述发现，急性酒精消费会导致非酒精性和慢性酒精使用者的副交感神经和交感神经 HRV 效应降低。本综述调查了慢性酒精消费对酒精依赖受试者和非依赖使用者的 HRV 的影响。我们在 MEDLINE、Scopus 和 PubMed 上搜索了测量慢性酒精使用对 HRV 影响的人类实验和临床试验。仅审查了包括其研究设计描述以及明确说明数据收集和结果测量方法的出版物。我们总共审查了 24 篇文章。在非依赖使用者中，与饮酒频率较低或完全戒酒者相比，低剂量（接近女性推荐的每日 1 标准饮品量，男性为 2 标准饮品量）使用与 HRV 参数增加有关。与两者相比，进一步增加消耗与 HRV 降低有关。与更频繁饮酒者和适度饮酒者相比，停止饮酒后的 HRV 变化通常遵循相同的负面方向，但更为复杂且不太了解。在依赖受试者中，在禁欲后观察到 HRV 改善，但与非酒精对照相比仍然降低。本综述表明，与慢性使用相关的 HRV 变化遵循 J 形曲线。它支持限制男性每日饮酒量不超过 2 份，女性不超过 1 份的建议。未来的研究应将 HRV 作为酒精中毒发展和治疗反应的生物标志物以及酒精对 HRV 影响的生理基础进行研究。
