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静息心率的重要性。

Importance of resting heart rate.

机构信息

Division of Cardiology, Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.

Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Via dei Vestini, 33, Chieti 66100, Italy; Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden.

出版信息

Trends Cardiovasc Med. 2023 Nov;33(8):502-515. doi: 10.1016/j.tcm.2022.05.006. Epub 2022 May 25.

Abstract

Resting heart rate is a determinant of cardiac output and physiological homeostasis. Although a simple, but critical, parameter, this vital sign predicts adverse outcomes, including mortality, and development of diseases in otherwise normal and healthy individuals. Temporal changes in heart rate can have valuable predictive capabilities. Heart rate can reflect disease severity in patients with various medical conditions. While heart rate represents a compilation of physiological inputs, including sympathetic and parasympathetic tone, aside from the underlying intrinsic sinus rate, how resting heart rate affects outcomes is uncertain. Mechanisms relating resting heart rate to outcomes may be disease-dependent but why resting heart rate in otherwise healthy, normal individuals affects outcomes remains obscure. For specific conditions, physiologically appropriate heart rate reductions may improve outcomes. However, to date, in the normal population, evidence that interventions aimed at reducing heart rate improves outcomes remains undefined. Emerging data suggest that reduction in heart rate via vagal activation and/or sympathetic inhibition is propitious.

摘要

静息心率是心输出量和生理稳态的决定因素。尽管这是一个简单但关键的参数,但这个生命体征可以预测不良结局,包括死亡率和原本健康个体的疾病发展。心率的时间变化具有有价值的预测能力。心率可以反映各种医疗条件下患者的疾病严重程度。虽然心率反映了包括交感神经和副交感神经张力在内的生理输入的综合情况,但除了潜在的固有窦性率之外,静息心率如何影响结局尚不确定。与静息心率与结局相关的机制可能取决于疾病,但为什么在原本健康、正常的个体中,静息心率会影响结局仍不清楚。对于特定情况,生理上适当的心率降低可能会改善结局。然而,迄今为止,在正常人群中,旨在降低心率的干预措施是否能改善结局仍未得到明确证实。新出现的数据表明,通过迷走神经激活和/或交感神经抑制来降低心率是有利的。

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