Sun Cheuk-Kwan, Liu Cyuan-Cin, Liu Wei-Min, Wu Hsien-Tsai, Huang Ruay-Ming, Liu An-Bang
Department of Emergency Medicine, E-Da Hospital and I-Shou University College of Medicine, Kaohsiung, Taiwan.
Department of Electrical Engineering, National Dong Hwa University, Hualien, Taiwan.
Tzu Chi Med J. 2019 Feb 20;32(1):41-46. doi: 10.4103/tcmj.tcmj_68_18. eCollection 2020 Jan-Mar.
Heart rate variability (HRV) analysis using electrocardiographic R-R intervals (RRIs) in either a time or a frequency domain is a useful tool for assessing cardiac autonomic dysfunction in clinical research. For convenience, pulse-pulse intervals (PPIs) acquired by photoplethysmography have been used to assess HRV. However, the compatibility of PPI with RRI is controversial.
In this study, we investigated the compatibility of PPI with RRI in five groups of participants, including nonoverweight young individuals with a body mass index (BMI) <24 kg/m (Group 1, = 20, aged 18-40 years), overweight young individuals with a BMI ≥24 kg/m (Group 2, = 13, aged 21-38 years), nonoverweight upper middle-aged individuals with a BMI <24 kg/m (Group 3, = 21, aged 45-89 years), overweight upper middle-aged individuals with a BMI ≥24 kg/m (Group 4, = 14, aged 43-74 years), and diabetic patients with a BMI ≥24 kg/m (Group 5, = 19, aged 35-74 years). We then used cross-approximate entropy (CAE) to assess the compatibility between RRI and PPI and analyzed HRV in the time and frequency domains derived from PPR and RRI with traditional methods.
The CAE values in Group 1 were significantly lower than those in Group 2 (1.68 ± 0.16 vs. 1.78 ± 0.15, = 0.041), Group 3 (1.68 ± 0.16 vs. 2.05 ± 0.27, < 0.001), Group 4 (1.68 ± 0.16 vs. 1.87 ± 0.23, = 0.023), and Group 5 (1.68 ± 0.16 vs. 2.09 ± 0.23, < 0.001). There were no significant differences in HRV acquired by PPI and RRI, except for proportion of pairs of adjacent NN intervals differing by more than 50 ms in the entire recording in Group 1. All HRVs derived from PPI were different from those acquired from RRI in the other groups.
PPI may be an alternative parameter for effectively assessing cardiac autonomic function in nonoverweight healthy individuals. It should be used carefully in overweight, elderly, or diabetic individuals.
在临床研究中，使用心电图R-R间期（RRIs）在时域或频域进行心率变异性（HRV）分析是评估心脏自主神经功能障碍的有用工具。为方便起见，通过光电容积脉搏波描记法获取的脉搏-脉搏间期（PPIs）已被用于评估HRV。然而，PPI与RRI的兼容性存在争议。
在本研究中，我们调查了五组参与者中PPI与RRI的兼容性，包括体重指数（BMI）<24 kg/m²的非超重年轻个体（第1组，n = 20，年龄18 - 40岁）、BMI≥24 kg/m²的超重年轻个体（第2组，n = 13，年龄21 - 38岁）、BMI<24 kg/m²的非超重中年个体（第3组，n = 21，年龄45 - 89岁）、BMI≥24 kg/m²的超重中年个体（第4组，n = 14，年龄43 - 74岁）以及BMI≥24 kg/m²的糖尿病患者（第5组，n = 19，年龄35 - 74岁）。然后我们使用交叉近似熵（CAE）来评估RRI与PPI之间的兼容性，并采用传统方法分析从PPR和RRI得出的时域和频域中的HRV。
第1组的CAE值显著低于第2组（1.68±0.16 vs. 1.78±0.15，P = 0.041）、第3组（1.68±0.16 vs. 2.05±0.27，P < 0.001）、第4组（1.68±0.16 vs. 1.87±0.23，P = 0.023）和第5组（1.68±0.16 vs. 2.09±0.23，P < 0.001）。除了第1组整个记录中相邻NN间期相差超过50 ms的配对比例外，PPI和RRI获取的HRV没有显著差异。在其他组中，所有从PPI得出的HRV与从RRI获取的HRV均不同。
PPI可能是有效评估非超重健康个体心脏自主神经功能的替代参数。在超重、老年或糖尿病个体中应谨慎使用。
