van den Berg Marten E, Rijnbeek Peter R, Niemeijer Maartje N, Hofman Albert, van Herpen Gerard, Bots Michiel L, Hillege Hans, Swenne Cees A, Eijgelsheim Mark, Stricker Bruno H, Kors Jan A
Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands.
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands.
Front Physiol. 2018 Apr 27;9:424. doi: 10.3389/fphys.2018.00424. eCollection 2018.
Heart-rate variability (HRV) measured on standard 10-s electrocardiograms (ECGs) has been associated with increased risk of cardiac and all-cause mortality, but age- and sex-dependent normal values have not been established. Since heart rate strongly affects HRV, its effect should be taken into account. We determined a comprehensive set of normal values of heart-rate corrected HRV derived from 10-s ECGs for both children and adults, covering both sexes. Five population studies in the Netherlands (Pediatric Normal ECG Study, Leiden University Einthoven Science Project, Prevention of Renal and Vascular End-stage Disease Study, Utrecht Health Project, Rotterdam Study) provided 10-s, 12-lead ECGs. ECGs were stored digitally and analyzed by well-validated analysis software. We included cardiologically healthy participants, 42% being men. Their ages ranged from 11 days to 91 years. After quality control, 13,943 ECGs were available. Heart-rate correction formulas were derived using an exponential model. Two time-domain HRV markers were analyzed: the corrected standard deviation of the normal-to-normal RR intervals (SDNNc) and corrected root mean square of successive RR-interval differences (RMSSDc). There was a considerable age effect. For both SDNNc and RMSSDc, the median and the lower limit of normal decreased steadily from birth until old age. The upper limit of normal decreased until the age of 60, but increased markedly after that age. Differences of the median were minimal between men and women. We report the first comprehensive set of normal values for heart-rate corrected 10-s HRV, which can be of value in clinical practice and in further research.
在标准10秒心电图(ECG)上测量的心率变异性(HRV)与心脏和全因死亡率风险增加相关,但年龄和性别依赖性正常参考值尚未确定。由于心率对HRV有强烈影响,因此应考虑其影响。我们确定了一套全面的、基于10秒ECG得出的心率校正HRV正常参考值,涵盖儿童和成人,包括男性和女性。荷兰的五项人群研究(儿科正常心电图研究、莱顿大学艾因托芬科学项目、预防肾脏和血管终末期疾病研究、乌得勒支健康项目、鹿特丹研究)提供了10秒12导联心电图。心电图以数字方式存储,并通过经过充分验证的分析软件进行分析。我们纳入了心脏健康的参与者,其中42%为男性。他们的年龄范围从11天到91岁。经过质量控制后,共获得13943份心电图。使用指数模型推导心率校正公式。分析了两个时域HRV指标:校正后的正常到正常RR间期标准差(SDNNc)和校正后的连续RR间期差值均方根(RMSSDc)。年龄效应显著。对于SDNNc和RMSSDc,正常参考值的中位数和下限从出生到老年稳步下降。正常参考值的上限在60岁之前下降,但在该年龄之后显著上升。男性和女性的中位数差异最小。我们报告了第一套全面的心率校正10秒HRV正常参考值,这在临床实践和进一步研究中可能具有价值。
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