da Silva Débora Martins, Macedo Murilo Carneiro, Lemos Lucas Brasileiro, Vieira Fernando Costa, Pirôpo Uanderson Silva, Andrade Helder Brito, Wessel Niels, Pereira Rafael
Biomed Tech (Berl). 2016 Dec 1;61(6):623-630. doi: 10.1515/bmt-2015-0239.
The study of heart autonomic control (HAC) in patients with chronic kidney disease (CKD) undergoing dialysis treatment has been carried out, however, there are no studies reporting the reliability of measurements of HAC parameters involving the mentioned samples and conditions. The reliability of many HAC parameters was evaluated from patients with CKD during two sessions of hemodialysis. The successive R-R intervals were recorded during two sessions of hemodialysis from 14 CKD patients that were undergoing dialysis for at least 6 months and with no history of recurrent hypotensive events. HAC parameters were obtained with time and frequency domain analysis, as well as with nonlinear methods. The reliability was measured with the intraclass correlation coefficient (ICC). The results showed excellent reliability (ICC=0.90-0.98) for most heart rate variability (HRV) parameters, especially the parameters obtained in the time domain [square root of the mean squared differences between successive R-R intervals (RMSSD), percentage of adjacent R-R intervals that differ by more than 50 ms (pNN50), mean of the 5-min standard deviations of R-R intervals (SDNNi), and triangular index] and with non-linear methods [standard deviation of the instantaneous variability beat-to-beat (SD1), standard deviation in long-term continuous R-R intervals (SD2), detrended fluctuation analysis (DFA) α1 and α2, approximate and sample entropies, and correlation dimension (D2): ICC=0.86-0.96]. Among the parameters obtained in the frequency domain (normalized magnitude from the spectrum of low-frequency components (LFnu), normalized magnitude from the spectrum of high-frequency components (HFnu), and LF/HF ratio), the LF/HF ratio showed better reliability (ICC=0.96 vs. ICC=0.70). Measurements of HAC parameters have excellent test-retest reliability for the studied samples and conditions.
已经对接受透析治疗的慢性肾脏病（CKD）患者的心脏自主神经控制（HAC）进行了研究，然而，尚无研究报告涉及上述样本和条件的HAC参数测量的可靠性。在两次血液透析期间，对CKD患者的许多HAC参数的可靠性进行了评估。从14例接受透析至少6个月且无复发性低血压事件病史的CKD患者的两次血液透析期间记录连续的R-R间期。通过时域和频域分析以及非线性方法获得HAC参数。用组内相关系数（ICC）测量可靠性。结果显示，大多数心率变异性（HRV）参数具有出色的可靠性（ICC = 0.90 - 0.98），尤其是在时域中获得的参数[连续R-R间期的均方差的平方根（RMSSD）、相差超过50毫秒的相邻R-R间期的百分比（pNN50）、R-R间期的5分钟标准差的平均值（SDNNi）和三角指数]以及非线性方法[逐搏瞬时变异性的标准差（SD1）、长期连续R-R间期的标准差（SD2）、去趋势波动分析（DFA）α1和α2、近似熵和样本熵以及关联维数（D2）：ICC = 0.86 - 0.96]。在频域中获得的参数[低频分量频谱的归一化幅值（LFnu）、高频分量频谱的归一化幅值（HFnu）和LF/HF比值]中，LF/HF比值显示出更好的可靠性（ICC = 0.96对ICC = 0.70）。对于所研究的样本和条件，HAC参数的测量具有出色的重测可靠性。
