Ernst Gernot
Anaesthesiology, Pain and Palliative Care Section, Kongsberg Hospital, Vestre Viken Hospital Trust, Kongsberg, Norway.
Front Public Health. 2017 Sep 11;5:240. doi: 10.3389/fpubh.2017.00240. eCollection 2017.
Heart-rate variability (HRV) is frequently introduced as mirroring imbalances within the autonomous nerve system. Many investigations are based on the paradigm that increased sympathetic tone is associated with decreased parasympathetic tone and . But HRV is probably more than an indicator for probable disturbances in the autonomous system. Some perturbations trigger not reciprocal, but parallel changes of vagal and sympathetic nerve activity. HRV has also been considered as a surrogate parameter of the complex interaction between brain and cardiovascular system. Systems biology is an inter-disciplinary field of study focusing on complex interactions within biological systems like the cardiovascular system, with the help of computational models and time series analysis, beyond others. Time series are considered surrogates of the particular system, reflecting robustness or fragility. Increased variability is usually seen as associated with a good health condition, whereas lowered variability might signify pathological changes. This might explain why lower HRV parameters were related to decreased life expectancy in several studies. Newer integrating theories have been proposed. According to them, HRV reflects as much the state of the heart as the state of the brain. The polyvagal theory suggests that the physiological state dictates the range of behavior and psychological experience. Stressful events perpetuate the rhythms of autonomic states, and subsequently, behaviors. Reduced variability will according to this theory not only be a surrogate but represent a fundamental homeostasis mechanism in a pathological state. The neurovisceral integration model proposes that cardiac vagal tone, described in HRV beyond others as HF-index, can mirror the functional balance of the neural networks implicated in emotion-cognition interactions. Both recent models represent a more holistic approach to understanding the significance of HRV.
心率变异性（HRV）常被视为反映自主神经系统内失衡情况的指标。许多研究基于这样的范式：交感神经张力增加与副交感神经张力降低相关。但HRV可能不仅仅是自主系统潜在紊乱的一个指标。一些干扰引发的不是迷走神经和交感神经活动的相互变化，而是平行变化。HRV也被视为大脑与心血管系统之间复杂相互作用的替代参数。系统生物学是一个跨学科研究领域，借助计算模型和时间序列分析等手段，专注于生物系统（如心血管系统）内的复杂相互作用。时间序列被视为特定系统的替代物，反映其稳健性或脆弱性。变异性增加通常被视为与良好的健康状况相关，而变异性降低可能意味着病理变化。这或许可以解释为什么在几项研究中较低的HRV参数与预期寿命缩短有关。已经提出了更新的整合理论。根据这些理论，HRV既反映心脏状态，也反映大脑状态。多元迷走神经理论认为，生理状态决定行为和心理体验的范围。应激事件使自主状态的节律持续存在，进而导致行为持续。根据这一理论，变异性降低不仅是一种替代指标，而且代表病理状态下的一种基本稳态机制。神经内脏整合模型提出，HRV中以高频指数（HF-index）最为突出描述的心脏迷走神经张力，可以反映参与情绪 - 认知相互作用的神经网络的功能平衡。这两种最新模型都代表了一种更全面的方法来理解HRV的意义。
