Maciorowska Małgorzata, Krzesiński Paweł, Wierzbowski Robert, Uziębło-Życzkowska Beata, Gielerak Grzegorz
Department of Cardiology and Internal Diseases, Military Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw, Poland.
J Clin Med. 2022 Jun 29;11(13):3767. doi: 10.3390/jcm11133767.
Autonomic nervous system (ANS) dysfunction is an important factor in the development and progression of arterial hypertension (AH) and may produce adverse hemodynamic sequelae. ANS function can be evaluated by analyzing heart rate variability (HRV). The purpose of this study was to assess the possible correlation between HRV and the hemodynamic profile of AH patients, including antihypertensive treatment effects after 12 months.
The study was conducted on 144 patients with uncomplicated AH. The hemodynamic profile was assessed via echocardiography and impedance cardiography (ICG). The analyzed HRV parameters included SDNN, rMSSD, pNN50, low frequency (LF, 0.05-0.15 Hz), high frequency (HF, 0.15-0.4 Hz), total power (TP, the variance of all NN intervals), and the day, night, and 24-h low-to-high frequency ratios (LF/HF).
Analysis showed various correlations of HRV parameters both with arterial blood pressure and with the hemodynamic profile assessed via echocardiography and ICG. The HRV parameters of increased ANS activity showed a correlation with improved left ventricle function (LV) and lower LV afterload.
Effective antihypertensive treatment demonstrated beneficial effects on both the ANS balance and the hemodynamic profile.
自主神经系统（ANS）功能障碍是动脉高血压（AH）发生和发展的重要因素，可能产生不良的血流动力学后果。可通过分析心率变异性（HRV）来评估ANS功能。本研究的目的是评估HRV与AH患者血流动力学特征之间的可能相关性，包括12个月后的降压治疗效果。
对144例无并发症的AH患者进行了研究。通过超声心动图和阻抗心动图（ICG）评估血流动力学特征。分析的HRV参数包括标准差（SDNN）、相邻RR间期差值的均方根（rMSSD）、差值大于50ms的相邻RR间期所占百分比（pNN50）、低频（LF，0.05 - 0.15Hz）、高频（HF，0.15 - 0.4Hz）、总功率（TP，所有正常RR间期的方差）以及日间、夜间和24小时低频与高频比值（LF/HF）。
分析表明，HRV参数与动脉血压以及通过超声心动图和ICG评估的血流动力学特征之间存在多种相关性。ANS活动增加的HRV参数与左心室功能（LV）改善和较低的LV后负荷相关。
有效的降压治疗对ANS平衡和血流动力学特征均显示出有益效果。
