Lucini Daniela, Marchetti Ilaria, Spataro Antonio, Malacarne Mara, Benzi Manuela, Tamorri Stefano, Sala Roberto, Pagani Massimo
University of Milano, BIOMETRA, via Vanvitelli 32, Milano 20129, Italy; Sezione Medicina dell'Esercizio e Patologie Funzionali, Humanitas Clinical and Research Center, via Manzoni 56, Rozzano 20089, Italy.
University of Milano, BIOMETRA, via Vanvitelli 32, Milano 20129, Italy.
Int J Cardiol. 2017 Aug 1;240:307-312. doi: 10.1016/j.ijcard.2017.05.001. Epub 2017 May 3.
Spectral analysis of Heart Rate Variability (HRV) is a simple, non-invasive technique that is widely used in sport to assess sympatho-vagal regulation of the heart. Its employment is increasing partly due to the rising usage of wearable devices. However data acquisition using these devices may be suboptimal because they cannot discriminate between sinus and non-sinus beats and do not record any data regarding respiratory frequency. This information is mandatory for a correct clinical interpretation.
This study involved 974 elite athletes, all of them underwent a complete autonomic assessment, by way of Autoregressive HRV analysis.
In 91 subjects (9% of the total population) we observed criticalities of either cardiac rhythm or respiration. Through perusal of one-lead ECG analysis we observed that 77 subjects had atrial or ventricular ectopy, i.e. conditions which impair stationarity and sinus rhythm. Running anyway autonomic nervous system analysis in this population, we observed that RR variance and raw values of LF and HF regions are significantly higher in arrhythmic subjects. In addition 14 subjects had slow (about 6 breath/min, 0.1Hz) respiration. This condition clouds the separation between LF from HF spectral regions of RR interval variability, respectively markers of the prevalent sympathetic and vagal modulation of SA node and of their synergistic interaction.
Caution must be payed when assessing HRV with non-ECG wearable devices. Recording ECG signal and ensuring that respiratory rate is higher than 10 breath/min are both prerequisites for a more reliable analysis of HRV particularly in athletes.
心率变异性（HRV）的频谱分析是一种简单的非侵入性技术，在体育领域被广泛用于评估心脏的交感-迷走神经调节。其应用的增加部分归因于可穿戴设备使用的增多。然而，使用这些设备进行数据采集可能并不理想，因为它们无法区分窦性和非窦性搏动，也不记录任何有关呼吸频率的数据。而这些信息对于正确的临床解读是必不可少的。
本研究纳入了974名精英运动员，他们均通过自回归HRV分析接受了全面的自主神经评估。
在91名受试者（占总人群的9%）中，我们观察到了心律或呼吸方面的问题。通过单导联心电图分析，我们发现77名受试者存在房性或室性异位心律，即影响平稳性和窦性心律的情况。尽管对该人群进行了自主神经系统分析，但我们观察到心律失常受试者的RR间期方差以及低频（LF）和高频（HF）区域的原始值显著更高。此外，14名受试者呼吸缓慢（约6次/分钟，0.1Hz）。这种情况模糊了RR间期变异性的LF和HF频谱区域之间的区分，这两个区域分别是窦房结主要交感和迷走神经调节及其协同相互作用的标志物。
使用非心电图可穿戴设备评估HRV时必须谨慎。记录心电图信号并确保呼吸频率高于10次/分钟，这两者都是更可靠地分析HRV的前提条件，尤其是在运动员中。
