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健康成年人中经混杂因素校正后的心率变异性与肺功能之间的相关性。

Correlation between heart rate variability and pulmonary function adjusted by confounding factors in healthy adults.

作者信息

Bianchim M S, Sperandio E F, Martinhão G S, Matheus A C, Lauria V T, da Silva R P, Spadari R C, Gagliardi A R T, Arantes R L, Romiti M, Dourado V Z

机构信息

Laboratório de Epidemiologia e Movimento Humano, Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil.

Departamento de Biociências, Universidade Federal de São Paulo, Santos, SP, Brasil.

出版信息

Braz J Med Biol Res. 2016 Mar;49(3). doi: 10.1590/1414-431X20154435. Epub 2016 Feb 2.

Abstract

The autonomic nervous system maintains homeostasis, which is the state of balance in the body. That balance can be determined simply and noninvasively by evaluating heart rate variability (HRV). However, independently of autonomic control of the heart, HRV can be influenced by other factors, such as respiratory parameters. Little is known about the relationship between HRV and spirometric indices. In this study, our objective was to determine whether HRV correlates with spirometric indices in adults without cardiopulmonary disease, considering the main confounders (e.g., smoking and physical inactivity). In a sample of 119 asymptomatic adults (age 20-80 years), we evaluated forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). We evaluated resting HRV indices within a 5-min window in the middle of a 10-min recording period, thereafter analyzing time and frequency domains. To evaluate daily physical activity, we instructed participants to use a triaxial accelerometer for 7 days. Physical inactivity was defined as <150 min/week of moderate to intense physical activity. We found that FVC and FEV1, respectively, correlated significantly with the following aspects of the RR interval: standard deviation of the RR intervals (r =0.31 and 0.35), low-frequency component (r =0.38 and 0.40), and Poincaré plot SD2 (r =0.34 and 0.36). Multivariate regression analysis, adjusted for age, sex, smoking, physical inactivity, and cardiovascular risk, identified the SD2 and dyslipidemia as independent predictors of FVC and FEV1 (R2=0.125 and 0.180, respectively, for both). We conclude that pulmonary function is influenced by autonomic control of cardiovascular function, independently of the main confounders.

摘要

自主神经系统维持体内平衡,即身体的平衡状态。通过评估心率变异性(HRV)可以简单且非侵入性地确定这种平衡。然而,独立于心脏的自主控制之外,HRV还可能受到其他因素的影响,如呼吸参数。关于HRV与肺功能指标之间的关系,目前知之甚少。在本研究中,我们的目的是确定在没有心肺疾病的成年人中,考虑到主要混杂因素(如吸烟和身体活动不足)时,HRV是否与肺功能指标相关。在119名无症状成年人(年龄20 - 80岁)的样本中,我们评估了用力肺活量(FVC)和第1秒用力呼气量(FEV1)。我们在10分钟记录期中间的5分钟窗口内评估静息HRV指标,随后分析时域和频域。为了评估日常身体活动,我们指示参与者使用三轴加速度计7天。身体活动不足定义为每周中度至剧烈身体活动<150分钟。我们发现FVC和FEV1分别与RR间期的以下方面显著相关:RR间期标准差(r = 0.31和0.35)、低频成分(r = 0.38和0.40)以及庞加莱图SD2(r = 0.34和0.36)。在对年龄、性别、吸烟、身体活动不足和心血管风险进行调整的多变量回归分析中,确定SD2和血脂异常是FVC和FEV1的独立预测因素(两者的R2分别为0.125和0.180)。我们得出结论,肺功能受心血管功能自主控制的影响,独立于主要混杂因素。

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