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高血压患者心率变异性的非线性分析

Nonlinear analyses of heart rate variability in hypertension.

作者信息

Koichubekov B K, Sorokina M A, Laryushina Y M, Turgunova L G, Korshukov I V

机构信息

Karaganda State Medical University, Gogol street 40, 100008 Karaganda, Kazakhstan.

出版信息

Ann Cardiol Angeiol (Paris). 2018 Jun;67(3):174-179. doi: 10.1016/j.ancard.2018.04.014. Epub 2018 May 9.

Abstract

OBJECTIVE

The autonomic nervous system plays an important role in blood pressure regulation and in the development of hypertension. Heart rate variability (HRV) may be of importance in identifying subjects at higher risk of developing hypertension. In the present study, comparative analysis of HRV for normal and hypertension subjects using nonlinear indices has been carried out.

PATIENTS AND METHODS

We analyzed the data from 24 patients with essential hypertension aged 45-55 (HG). All the subjects in this group had a confirmed diagnosis of the first- or second-stage essential hypertension. The control group for these subjects included 32 healthy volunteers of the same age group (CG). We analyzed the whole 5minutes of the ECG recording. Nonlinear indices D, K and lagged Poincaré plot indices were calculated.

RESULTS

Values of D and K in hypertension state is statistically significantly lower than in healthy. Poincaré plot indices SD1 and SD2 in healthy volunteers are statistically higher than in hypertensive patients for all lags (P<0,05). SD1/SD2 ratio is also higher in healthy subjects, but the difference is statistically significant only for l=5 and 6.

CONCLUSION

The heart rhythm in groups with hypertension is more regular, its dynamics are less complex and less "chaotic," compared to healthy ones. This is expressed in lower values of entropy and correlation dimension. The HR stabilization is observed at both short and long time intervals, but mainly due to the decrease in the difference of the "neighboring" R-R intervals.

摘要

目的

自主神经系统在血压调节和高血压发展过程中发挥着重要作用。心率变异性(HRV)对于识别高血压发病风险较高的个体可能具有重要意义。在本研究中,已使用非线性指标对正常人和高血压患者的HRV进行了比较分析。

患者与方法

我们分析了24例年龄在45 - 55岁的原发性高血压患者(HG组)的数据。该组所有受试者均确诊为一期或二期原发性高血压。这些受试者的对照组包括32名同年龄组的健康志愿者(CG组)。我们分析了整个5分钟的心电图记录。计算了非线性指标D、K以及滞后庞加莱图指标。

结果

高血压状态下D和K的值在统计学上显著低于健康状态。对于所有滞后情况,健康志愿者的庞加莱图指标SD1和SD2在统计学上均高于高血压患者(P<0.05)。健康受试者的SD1/SD2比值也更高,但仅在滞后l = 5和6时差异具有统计学意义。

结论

与健康人群相比,高血压组的心律更规则,其动态变化更不复杂且更不“混沌”。这表现为熵值和关联维数较低。在短时间和长时间间隔内均观察到HR稳定,但主要是由于“相邻”R - R间期差异的减小。

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