Montaño Alexandra, Brown Freddy, Credeur Daniel P, Williams Michelle A, Stoner Lee
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
School of Sport and Exercise, Massey University, Wellington, New Zealand.
Clin Physiol Funct Imaging. 2017 Jul;37(4):421-427. doi: 10.1111/cpf.12320. Epub 2016 Jan 7.
Analysis of heart rate variability (HRV) responses to an orthostatic challenge can be used to investigate autonomic control of heart rate, an index of cardiovascular function. HRV is typically assessed using the electrocardiogram (ECG), which can be impractical for use with large population-based studies.
To assess the validity and reliability of telemetry-derived HRV responses to an orthostatic challenge.
Twenty healthy adults (26 + 5 years, 45% male) were tested on three separate mornings. Following 20-min supine rest, R-R intervals were recorded using a telemetric device during three conditions: BASE, TILT and RECOVERY. ECG was simultaneously used on 1 day for validity comparison. Measures of HRV included the following: standard deviation of normal-to-normal intervals (SDNN), the root-mean-square of successive differences (RMSSD) and the low-frequency (LF) and high-frequency (HF) spectral power.
For all parameters, there was excellent agreement between devices for BASE (r = 0·96-0·99), TILT (r = 0·89-1·00) and RECOVERY (r = 0·96-1·00). For the telemetric device, between-day intraclass coefficient values for RMSDD, SDNN and HF were all above the 0·75 criterion for each condition, indicating excellent between-day reliability. For each condition, the reliability coefficient, expressed as a percentage of the mean (RC%), was marginally lower (greater reliability) for RMSDD (RC% 11-13) and SDNN (RC% 10-12) compared to HF (RC% 12-17). However, SDNN did not significantly respond to the orthostatic challenge.
Telemetric HRV, particularly RMSDD and HF, can be used to provide a sensitive, valid and reliable assessment of autonomic control of heart rate.
分析心率变异性(HRV)对直立性应激的反应可用于研究心率的自主控制,这是心血管功能的一个指标。HRV通常使用心电图(ECG)进行评估,这对于大规模人群研究来说可能不切实际。
评估遥测得出的HRV对直立性应激反应的有效性和可靠性。
20名健康成年人(26±5岁,45%为男性)在三个不同的早晨接受测试。在仰卧休息20分钟后,使用遥测设备在三种状态下记录R-R间期:基础状态(BASE)、倾斜状态(TILT)和恢复状态(RECOVERY)。在其中一天同时使用ECG进行有效性比较。HRV的测量指标包括:正常到正常间期的标准差(SDNN)、连续差值的均方根(RMSSD)以及低频(LF)和高频(HF)谱功率。
对于所有参数,在基础状态(r = 0·96 - 0·99)、倾斜状态(r = 0·89 - 1·00)和恢复状态(r = 0·96 - 1·00)下,两种设备之间的一致性都非常好。对于遥测设备,RMSSD、SDNN和HF在各状态下的日间组内相关系数值均高于0·75的标准,表明日间可靠性极佳。对于每种状态,以均值百分比表示的可靠性系数(RC%),与HF(RC% 12 - 17)相比,RMSSD(RC% 11 - 13)和SDNN(RC% 10 - 12)略低(可靠性更高)。然而,SDNN对直立性应激没有显著反应。
遥测HRV,尤其是RMSSD和HF,可用于提供对心率自主控制的敏感、有效和可靠评估。