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残余心率变异性测量能更好地区分急性心肌梗死患者和冠状动脉通畅的患者。

Residual heart rate variability measures can better differentiate patients with acute myocardial infarction from patients with patent coronary artery.

作者信息

Jiang Jiunn-Song, Kor Chew-Teng, Kuo David Dar, Lin Ching-Hsiung, Chang Chia-Chu, Chen Gau-Yang, Kuo Cheng-Deng

机构信息

Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.

Departments of Internal Medicine, Taipei Medical University School of Medicine, Taipei, Taiwan.

出版信息

Ther Clin Risk Manag. 2018 Oct 8;14:1923-1931. doi: 10.2147/TCRM.S178734. eCollection 2018.

Abstract

PURPOSE

It has been shown that the power spectral density (PSD) of heart rate variability (HRV) can be decomposed into a power-law function and a residual PSD (rPSD) with a more prominent high-frequency component than that in traditional PSD. This study investigated whether the residual HRV (rHRV) measures can better discriminate patients with acute myocardial infarction (AMI) from patients with patent coronary artery (PCA) than traditional HRV measures.

MATERIALS AND METHODS

The rHRV and HRV measures of 48 patients with AMI and 69 patients with PCA were compared.

RESULTS

The high-frequency power of rHRV spectrum was significantly enhanced while the low-frequency and very low-frequency powers of rHRV spectrum were significantly suppressed, as compared to their corresponding traditional HRV spectrum in both groups of patients. The normalized residual high-frequency power (nrHFP = residual high-frequency power/residual total power) was significantly greater than the corresponding normalized high-frequency power in both groups of patients. Between-groups comparison showed that the nrHFP in AMI patients was significantly smaller than that in PCA patients. Receiver operating characteristic curve analysis showed that the nrHFP or nrHFP + normalized residual very low-frequency power (residual very low-frequency power/rTP) had better discrimination capability than the corresponding HRV measures for predicting AMI.

CONCLUSIONS

Compared with traditional HRV measures, the rHRV measures can slightly better differentiate AMI patients from PCA patients, especially the nrHFP or nrHFP + normalized residual very low-frequency power.

摘要

目的

研究表明,心率变异性(HRV)的功率谱密度(PSD)可分解为幂律函数和残余PSD(rPSD),其高频成分比传统PSD更为显著。本研究旨在探讨残余HRV(rHRV)指标在区分急性心肌梗死(AMI)患者和冠状动脉通畅(PCA)患者方面是否比传统HRV指标表现更优。

材料与方法

比较了48例AMI患者和69例PCA患者的rHRV及HRV指标。

结果

与两组患者相应的传统HRV频谱相比,rHRV频谱的高频功率显著增强,而低频和极低频功率显著降低。两组患者的归一化残余高频功率(nrHFP = 残余高频功率/残余总功率)均显著高于相应的归一化高频功率。组间比较显示,AMI患者的nrHFP显著低于PCA患者。受试者工作特征曲线分析表明,nrHFP或nrHFP + 归一化残余极低频功率(残余极低频功率/rTP)在预测AMI方面比相应的HRV指标具有更好的辨别能力。

结论

与传统HRV指标相比,rHRV指标在区分AMI患者和PCA患者方面表现稍优,尤其是nrHFP或nrHFP + 归一化残余极低频功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e195/6183588/5c3477907db8/tcrm-14-1923Fig1.jpg

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