Lehavi Amit, Golomb Neta, Leiba Ronit, Katz Yeshayahu Shai, Raz Aeyal
Department of Anesthesiology, Rambam Health Care Campus, the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Department of Epidemiology, Rambam Health Care Campus, the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Physiol Rep. 2019 Jan;7(1):e13948. doi: 10.14814/phy2.13948.
Heart rate variability (HRV) reflects cardiac and autonomic nervous system activity. It is usually measured over a relatively prolonged period and presented using multiple parameters. Here, we studied rapid HRV changes during airway obstruction using a short (1 min) sampling window. Forty healthy volunteers underwent a trial of obstructed breathing. Heart rate was recorded during three consecutive sets comprised of 1-min control followed by 1 min of obstructed breathing, with 1 min of rest between sets. Time and frequency domain analysis were used to compare HRV during control versus obstructed breathing. Compared with control, HRV intensely increased during obstructed breathing: R-R intervals (time between consecutive R waves) standard deviation increased from 65 to 108 msec (P < 0.0001), root mean square of successive R-R interval from 61 to 82 msec (P = 0.001), number of pairs of successive R-R intervals that differ by more than 50 msec (NN50) from 16.5 to 25.3 events (P < 0.0001), and proportion of NN50 divided by total number of R-R intervals from 26.6 to 35.1% (P = 0.001). Low frequency power increased by more than fourfold (P < 0.0001), allowing 90% sensitivity and 75% specificity for identifying airway obstruction (ROC area 0.88, P < 0.0001). We observed a rapid intense increase in HRV during obstructed breathing, significant enough to detect during a short 1-min sampling window. These findings suggest that HRV may be useful for rapid detection of airway obstruction, especially in situations where end-tidal CO monitoring is not optimal, such as during partial airway obstruction.
心率变异性（HRV）反映心脏和自主神经系统活动。它通常在相对较长的时间段内进行测量，并使用多个参数来呈现。在此，我们使用短（1分钟）采样窗口研究气道阻塞期间HRV的快速变化。40名健康志愿者接受了阻塞呼吸试验。在由1分钟对照随后1分钟阻塞呼吸组成的连续三组试验中记录心率，组间休息1分钟。使用时域和频域分析来比较对照呼吸与阻塞呼吸期间的HRV。与对照相比，阻塞呼吸期间HRV显著增加：R-R间期（连续R波之间的时间）标准差从65毫秒增加到108毫秒（P < 0.0001），连续R-R间期的均方根从61毫秒增加到82毫秒（P = 0.001），相差超过50毫秒的连续R-R间期对的数量（NN50）从16.5次增加到25.3次（P < 0.0001），以及NN50除以R-R间期总数的比例从26.6%增加到35.1%（P = 0.001）。低频功率增加超过四倍（P < 0.0001），对气道阻塞的识别具有90%的敏感性和75%的特异性（ROC面积0.88，P < 0.0001）。我们观察到阻塞呼吸期间HRV快速显著增加，足以在短1分钟采样窗口内检测到。这些发现表明HRV可能有助于气道阻塞的快速检测，特别是在呼气末二氧化碳监测不理想的情况下，如部分气道阻塞期间。
