Koch Eva Charlotte, Staab Johanna, Fuest Matthias, Witt Katharina, Voss Andreas, Plange Niklas
Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52072 Aachen, Germany.
Department of Medical Engineering and Biotechnology, Ernst-Abbe-Hochschule Jena, 07745 Jena, Germany.
J Ophthalmol. 2015;2015:798958. doi: 10.1155/2015/798958. Epub 2015 Oct 1.
Purpose. To investigate blood pressure and heart rate variability in patients with primary open-angle glaucoma (POAG) to detect disturbed blood pressure regulation. Methods. Thirty-one patients with POAG (mean age 68 ± 10 years) and 48 control subjects (mean age 66 ± 10 years) were included in a prospective study. Continuous blood pressure and heart rate were simultaneously and noninvasively recorded over 30 min (Glaucoscreen, aviant GmbH, Jena, Germany). Data were analyzed calculating univariate linear (time domain and frequency domain), nonlinear (Symbolic Dynamics, SD) and bivariate (Joint Symbolic Dynamics, JSD) indices. Results. Using nonlinear methods, glaucoma patients were separated with more parameters compared to linear methods. In POAG, nonlinear univariate indices (pW113 and pW120_Sys) were increased while the indices pTH10_Sys and pTH11_Sys reflect a reduction of dominant patterns. Bivariate indices (JSDdia29, JSDdia50, and JSDdia52; coupling between heart rate and diastolic blood pressure) were increased in POAG. The optimum set consisting of six parameters (JSDdia29, JSDdia58, pTH9_Sys, pW231, pW110_Sys and pW120_Sys) revealed a sensitivity of 83.3% and specificity of 80.6%. Conclusions. Nonlinear uni- and bivariate indices of continuous recordings of blood pressure and heart rate are altered in glaucoma. Abnormal blood pressure variability suggests disturbed autonomic regulation in patients with glaucoma.
目的。研究原发性开角型青光眼（POAG）患者的血压和心率变异性，以检测血压调节紊乱情况。方法。一项前瞻性研究纳入了31例POAG患者（平均年龄68±10岁）和48例对照者（平均年龄66±10岁）。通过无创方式同时连续记录30分钟的血压和心率（使用德国耶拿的avian GmbH公司的Glaucoscreen设备）。对数据进行分析，计算单变量线性（时域和频域）、非线性（符号动力学，SD）和双变量（联合符号动力学，JSD）指标。结果。与线性方法相比，使用非线性方法能通过更多参数区分青光眼患者。在POAG患者中，非线性单变量指标（pW113和pW120_Sys）升高，而pTH10_Sys和pTH11_Sys指标反映出主导模式减少。双变量指标（JSDdia29、JSDdia50和JSDdia52；心率与舒张压之间的耦合）在POAG患者中升高。由六个参数（JSDdia29、JSDdia58、pTH9_Sys、pW231、pW110_Sys和pW120_Sys）组成的最佳组合显示出83.3%的敏感性和80.6%的特异性。结论。青光眼患者血压和心率连续记录的非线性单变量和双变量指标发生改变。血压变异性异常提示青光眼患者存在自主神经调节紊乱。
