验证脉搏率变异性作为长期植入仪器的兔子的心率变异性的替代指标。

Validation of pulse rate variability as a surrogate for heart rate variability in chronically instrumented rabbits.

机构信息

Department of Cellular and Integrative Physiology, The University of Nebraska Medical Center, Omaha, Nebraska.

Department of Cellular and Integrative Physiology, The University of Nebraska Medical Center, Omaha, Nebraska

出版信息

Am J Physiol Heart Circ Physiol. 2014 Jul 1;307(1):H97-109. doi: 10.1152/ajpheart.00898.2013. Epub 2014 May 2.

Abstract

Heart rate variability (HRV) is a function of cardiac autonomic tone that is widely used in both clinical and animal studies. In preclinical studies, HRV measures are frequently derived using the arterial pulse waveform from an implanted pressure telemetry device, termed pulse rate variability (PRV), instead of the electrocardiogram signal in accordance with clinical guidelines. The acceptability of PRV as a surrogate for HRV in instrumented animals is unknown. Using rabbits implanted with intracardiac leads and chronically implanted pressure transducers, we investigated the correlation and agreement of time-domain, frequency-domain, and nonlinear indexes of HRV and PRV at baseline. We also investigated the effects of ventricular pacing and autonomic blockade on both measures. At baseline, HRV and PRV time- and frequency-domain parameters showed robust correlations and moderate to high agreement, whereas nonlinear parameters showed slightly weaker correlations and varied agreement. Ventricular pacing almost completely eliminated HRV, and spectral analysis of the PRV signal revealed a HRV-independent rhythm. After cardiac autonomic blockade with atropine or metoprolol, the changes in time- and non-normalized frequency-domain measures of PRV continued to show strong correlations and moderate to high agreement with corresponding changes in HRV measures. Blockade-induced changes in nonlinear PRV indexes correlated poorly with HRV changes and showed weak agreement. These results suggest that time- and frequency-domain measures of PRV are acceptable surrogates for HRV even in the context of changing cardiac autonomic tone, but caution should be used when nonlinear measures are a primary end point or when HRV is very low as HRV-independent rhythms may predominate.

摘要

心率变异性(HRV)是心脏自主神经张力的一个功能,广泛应用于临床和动物研究。在临床前研究中,HRV 测量通常使用植入式压力遥测设备的动脉脉搏波形(称为脉搏率变异性(PRV))而不是根据临床指南的心电图信号来获得。PRV 作为有创动物 HRV 的替代指标的可接受性尚不清楚。我们使用植入心内导联和慢性植入压力传感器的兔子,研究了 HRV 和 PRV 的时域、频域和非线性指标在基线时的相关性和一致性。我们还研究了心室起搏和自主神经阻断对这两种测量方法的影响。在基线时,HRV 和 PRV 的时-频域参数显示出很强的相关性和中等至高度的一致性,而非线性参数显示出较弱的相关性和不同的一致性。心室起搏几乎完全消除了 HRV,而 PRV 信号的频谱分析显示出与 HRV 无关的节律。在用阿托品或美托洛尔进行心脏自主神经阻断后,PRV 的时-非归一化频域测量的变化仍然与 HRV 测量的相应变化显示出很强的相关性和中等至高度的一致性。阻断诱导的非线性 PRV 指数的变化与 HRV 变化相关性较差,一致性较弱。这些结果表明,即使在心脏自主神经张力改变的情况下,PRV 的时-频域测量也可以作为 HRV 的可接受替代指标,但当非线性测量是主要终点或 HRV 非常低时(因为可能存在与 HRV 无关的节律),应谨慎使用。

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