心率变异性的时频域指标可预测 2 型糖尿病患者的心血管结局。
Time- and frequency-domain measures of heart rate variability predict cardiovascular outcome in patients with type 2 diabetes.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
出版信息
Diabetes Res Clin Pract. 2018 Sep;143:159-169. doi: 10.1016/j.diabres.2018.07.001. Epub 2018 Jul 10.
AIMS
To evaluate the association between impaired heart rate variability (HRV) and cardiovascular disease (CVD) in patients with type 2 diabetes (T2DM).
METHODS
A total of 655 patients with T2DM who underwent cardiovascular autonomic function testing were consecutively recruited and followed up prospectively. Time- and frequency-domain HRV were assessed for 5 min by beat-to-beat heart rate recording. We estimated the development of CVD events during a follow-up period.
RESULTS
During a median follow-up of 7.8 years, 9.6% (n = 49) of patients developed CVD (10.6 per 1000 patient-years). The mean age and diabetes duration were 54.9 ± 8.6 years and 9.4 ± 7.3 years, respectively. Patients who had cardiovascular autonomic neuropathy (CAN) had decreased HRV compared with those with normal autonomic function. Multivariable cox hazard regression analysis revealed the lowest 10th percentile of the SD of the normal-to-normal interval (HR 2.62; 95% CI 1.30-5.31), total power (HR 2.81; 95% CI 1.37-5.79), low-frequency power (HR 2.68; 95% CI 1.28-5.59), and high-frequency power (HR 2.24; 95% CI 1.09-4.59) were significant predictors for developing CVD in patients with T2DM.
CONCLUSIONS
Time- and frequency-domain measures of HRV independently predicted cardiovascular outcome in patients with T2DM.
目的
评估 2 型糖尿病（T2DM）患者心率变异性（HRV）受损与心血管疾病（CVD）的相关性。
方法
连续招募了 655 名接受心血管自主功能测试的 T2DM 患者，并进行前瞻性随访。通过逐拍心率记录评估 5 分钟的时域和频域 HRV。我们估计了随访期间 CVD 事件的发生情况。
结果
在中位数为 7.8 年的随访期间，9.6%（n=49）的患者发生了 CVD（每 1000 患者年 10.6 例）。患者的平均年龄和糖尿病病程分别为 54.9±8.6 岁和 9.4±7.3 年。与自主神经功能正常的患者相比，患有心血管自主神经病变（CAN）的患者 HRV 降低。多变量 Cox 风险回归分析显示，正常-正常间期标准差的最低第 10 百分位数（HR 2.62；95%CI 1.30-5.31）、总功率（HR 2.81；95%CI 1.37-5.79）、低频功率（HR 2.68；95%CI 1.28-5.59）和高频功率（HR 2.24；95%CI 1.09-4.59）是 T2DM 患者发生 CVD 的显著预测因子。
结论
HRV 的时频域测量独立预测了 T2DM 患者的心血管结局。
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