Nakai Yoshikatsu, Fujita Masatoshi, Nin Kazuko, Noma Shun'ichi, Teramukai Satoshi
Kyoto Institute of Health Sciences, Miyako Bldg. 502, Karasuma Oike Agaru Higashigawa, Nakagyo-ku, Kyoto 604-0845 Japan.
Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Biopsychosoc Med. 2015 Apr 23;9:12. doi: 10.1186/s13030-015-0032-6. eCollection 2015.
The mortality rate associated with anorexia nervosa (AN) is high, and death is mainly attributable to cardiac events. A wide range of autonomic nervous system disturbances may be mechanisms underlying the increased cardiovascular mortality and sudden death of patients with AN. Heart rate variability (HRV) has been proven to be a reliable noninvasive method for quantitative assessment of sympathetic and parasympathetic regulation of heart rate (HR). The longer the duration of illness of AN patients, the higher the mortality rate. However, there have been few reports on the relationship between the duration of illness and HRV in AN. Hence, the aims of this study were to compare the cardiac autonomic nervous activity (CANA) of female patients with AN and age-matched female controls and to evaluate the relationship between the duration of illness and the CANA of the AN patients.
We studied 14 female patients with AN and 22 age-matched healthy women. Beat-to-beat heart rate variability, recorded in a supine position, was investigated using power spectral analysis.
Mean heart rate was positively correlated with normalized high-frequency (HF: 0.15 to 0.40 Hz) power and negatively correlated with the low-frequency (LF: 0.04 to 0.15 Hz)/HF power (LF/HF) ratio of the controls. On the other hand, duration of illness was negatively correlated with normalized HF power and positively correlated with the LF/HF ratio of the AN patients.
These results suggest that, given that the LF/HF ratio is an estimate of cardiac sympathovagal balance, anorectic patients with a long illness duration display lower vagal tone (parasympathetic withdrawal) and high sympathetic tone.
神经性厌食症（AN）相关的死亡率很高，死亡主要归因于心脏事件。广泛的自主神经系统紊乱可能是AN患者心血管死亡率增加和猝死的潜在机制。心率变异性（HRV）已被证明是定量评估心率（HR）交感和副交感神经调节的可靠非侵入性方法。AN患者的病程越长，死亡率越高。然而，关于AN病程与HRV之间关系的报道很少。因此，本研究的目的是比较AN女性患者与年龄匹配的女性对照组的心脏自主神经活动（CANA），并评估病程与AN患者CANA之间的关系。
我们研究了14名AN女性患者和22名年龄匹配的健康女性。采用功率谱分析对仰卧位记录的逐搏心率变异性进行研究。
对照组的平均心率与标准化高频（HF：0.15至0.40Hz）功率呈正相关，与低频（LF：0.04至0.15Hz）/HF功率（LF/HF）比值呈负相关。另一方面，病程与AN患者的标准化HF功率呈负相关，与LF/HF比值呈正相关。
这些结果表明，鉴于LF/HF比值是心脏交感迷走神经平衡的一个指标，病程长的厌食症患者表现出较低的迷走神经张力（副交感神经退缩）和较高的交感神经张力。
