Katayama Pedro Lourenço, Dias Daniel Penteado Martins, Silva Luiz Eduardo Virgilio, Virtuoso-Junior Jair Sindra, Marocolo Moacir
Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo (USP), Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil.
Postgraduating Program in Physical Education and Sports, Federal University of Triangulo Mineiro (UFTM), Av. Tutunas, 490, Uberaba, MG, 38061-500, Brazil.
Aging Clin Exp Res. 2015 Oct;27(5):621-9. doi: 10.1007/s40520-015-0320-9. Epub 2015 Feb 12.
Frailty has been defined as a geriatric syndrome that results in high vulnerability to health adverse outcomes. This increased vulnerability state results from dysregulation of multiple physiological systems and its complex interactions. Thus, assessment of physiological systems integrity and of its dynamic interactions seems to be useful in the context of frailty management. Heart rate variability (HRV) analysis provides information about autonomic nervous system (ANS) function, which is responsible to control several physiologic functions. This study investigated the cardiac autonomic modulation by HRV analysis in community-dwelling elderly women classified as non-frail, pre-frail and frail. Twenty-three elderly women were assigned to the following groups: non-frail (n = 8), pre-frail (n = 8) and frail (n = 7). HRV assessment was performed through linear and non-linear analysis of cardiac interval variability. It was observed a higher sympathetic and lower parasympathetic modulation in frail when compared with non-frail and pre-frail groups (p < 0.05) as indicated by frequency domain indices. Additionally, frail group had a decreased 2LV % pattern (that reflects parasympathetic modulation) in the symbolic analysis in comparison with non-frail group. These findings suggest that frail elderly women present an autonomic imbalance characterized by a shift towards sympathetic predominance. Thus, monitoring ANS function in the context of frailty management may be an important strategy to prevention, diagnosis and treatment of this syndrome and its consequences.
衰弱被定义为一种老年综合征，会导致对健康不良后果的高度易感性。这种增加的易感性状态是由多个生理系统的失调及其复杂的相互作用导致的。因此，评估生理系统的完整性及其动态相互作用在衰弱管理中似乎是有用的。心率变异性（HRV）分析提供了有关自主神经系统（ANS）功能的信息，自主神经系统负责控制多种生理功能。本研究通过HRV分析调查了社区居住的老年女性（分为非衰弱、衰弱前期和衰弱）的心脏自主神经调节。23名老年女性被分配到以下组：非衰弱组（n = 8）、衰弱前期组（n = 8）和衰弱组（n = 7）。通过对心脏间期变异性的线性和非线性分析进行HRV评估。频域指标显示，与非衰弱组和衰弱前期组相比，衰弱组的交感神经调节更高，副交感神经调节更低（p < 0.05）。此外，与非衰弱组相比，衰弱组在符号分析中的2LV%模式（反映副交感神经调节）降低。这些发现表明，衰弱的老年女性存在以交感神经占优势为特征的自主神经失衡。因此，在衰弱管理中监测自主神经系统功能可能是预防、诊断和治疗该综合征及其后果的重要策略。
