BIOMETRA, University of Milan, Milan, Italy.
Adv Exp Med Biol. 2018;1065:191-205. doi: 10.1007/978-3-319-77932-4_13.
Since the seminal studies by Sayers (Ergonomics 16:17-32, 1973) and Akselrod et al. (Science 213:220-222, 1981) a few decades ago, it became clear that beat-by-beat oscillations in RR interval length (i.e. heart-rate variability [HRV]) contain information on underlying neural-control mechanisms based on the instantaneous balance between parasympathetic and sympathetic innervation. Over the years, the number of studies addressing HRV has increased markedly and now outnumbers 23,000. Despite such a large interest, there is still a continuing debate about interpretation of indices produced by computer analysis of HRV.The main part of studies relies on spectral techniques to extract parameters that are linked to hidden information. The general idea is that these proxies of autonomic regulation can be useful to clinical applications in various conditions in which autonomic dysregulation may play a role. There are, however, serious shortcomings related to algorithms, interpretation, and the hidden value of individual indices. In particular, it appears that specific training is necessary to interpret the hidden informational value of HRV. This technical complexity represents a severe barrier to large-scale clinical applications. Moreover, important differences in HRV separate the sexes, and age plays an additional confounding role.We present here a preliminary application of a novel unitary index of RR variability (Autonomic Nervous System Index of cardiac regulation) capable of providing information on the performance of autonomic regulation using a percentile rank position as projected on a large benchmark population. A summary of the underlying sympatho-vagal model is also presented.
自从几十年前 Sayers（《人类工效学》16:17-32，1973）和 Akselrod 等人（《科学》213:220-222，1981）的开创性研究以来，人们清楚地认识到 RR 间期长度（即心率变异性[HRV]）的逐拍振荡包含基于副交感神经和交感神经支配之间瞬时平衡的潜在神经控制机制的信息。多年来，研究 HRV 的数量显著增加，现在已经超过 23000 项。尽管人们对此非常感兴趣，但对于 HRV 计算机分析产生的指标的解释仍存在持续的争论。这些研究的主要部分依赖于频谱技术来提取与隐藏信息相关的参数。一般的想法是，这些自主调节的代理可以在各种可能存在自主失调的情况下对临床应用有用。然而，与算法、解释和个体指标的隐藏价值相关的严重缺陷仍然存在。特别是，似乎需要进行特定的培训才能解释 HRV 的隐藏信息价值。这种技术复杂性是大规模临床应用的严重障碍。此外，HRV 存在重要的性别差异，年龄也会产生额外的混杂作用。在这里，我们初步应用了一种新的 RR 变异性单一指数（心脏调节自主神经系统指数），该指数能够提供关于自主调节性能的信息，使用百分位数位置作为在大型基准人群上的投影。还介绍了基本的交感神经-迷走神经模型的概述。
