初学者和专家神经介入医生在模拟神经血管造影期间心率变异性的差异。
Differences in beginner and expert neurointerventionalists" heart rate variability during simulated neuroangiographies.
机构信息
TUM School of Medicine, Department of Anesthesiology and Intensive Care, Technical University of Munich, München, Germany.
Department of Opthalmology, Ludwig-Maximilians-University, LMU Klinikum, München, Germany.
出版信息
Interv Neuroradiol. 2024 Apr;30(2):195-201. doi: 10.1177/15910199221128439. Epub 2022 Sep 19.
BACKGROUND
Likewise work experience, heart rate variability (HRV) has repeatedly been correlated with improved performance under real life and simulator conditions. Using HRV as a correlate of workload, it is meaningful to assess the impact of work experience. To understand the impact of work experience on HRV metrics, we examined differences in HRV among experts and beginners during simulated endovascular neuroradiological procedures.
METHODS
Six inexperienced radiologists (beginners) and five experts in neurological endovascular intervention each performed 10 diagnostic angiographies on a Vascular Interventional System Trainer (VIST) simulator (Mentice AB, SW). Beyond total time, fluoroscopy time, and amount of contrast medium used, heart rate variability and the NASA-task load index were gathered as correlates of workload. The t-Test for independent samples as well as Mann-Whitney-U tests were applied for group-wise comparison between beginners and experts. Multivariate regression was used to assess the influence of age and expert status.
RESULTS
Ten participants completed all scenarios; one participant only completed the first five scenarios. Accordingly, 105 simulations were analyzed (beginners N = 60; experts N = 45, respectively). The heart rate variability of experts and beginners significantly differed in three time domain HRV metrics (decreased RMSSD, NN50, pNN50 in experts; all p < 0.05) as well as with respect to its distribution in the frequency spectrum (LF/HF ratio; p < 0.001, increased high frequency components in experts).
CONCLUSIONS
The HRV of beginners and expert neurointerventionalists significantly differed during simulated endovascular neuroradiological procedures. Experts presented decreased HRV, this could be a cardiovascular surrogate to the effort the subjects expend on their performance. It is in line with previous studies on vagal influences on the heart and cognitive-executive performance.
背景
同样的工作经验，心率变异性（HRV）也与现实生活和模拟条件下的表现提高反复相关。使用 HRV 作为工作量的相关指标，评估工作经验的影响是有意义的。为了了解工作经验对 HRV 指标的影响，我们检查了模拟血管内神经放射学程序中专家和初学者之间的 HRV 差异。
方法
六名没有经验的放射科医生（初学者）和五名神经血管介入专家在血管介入系统训练器（VIST）模拟器（Mentice AB，SW）上各进行了 10 次诊断血管造影。除了总时间、透视时间和使用的造影剂量外，心率变异性和 NASA 任务负荷指数也被作为工作量的相关指标收集。采用独立样本 t 检验和曼-惠特尼 U 检验对初学者和专家进行组间比较。采用多元回归评估年龄和专家状态的影响。
结果
10 名参与者完成了所有场景；一名参与者只完成了前五个场景。因此，分析了 105 次模拟（初学者 N=60；专家 N=45）。专家和初学者的心率变异性在三个时域 HRV 指标上存在显著差异（RMSSD、NN50、pNN50 降低，专家；所有 p<0.05），以及在频谱分布方面（LF/HF 比值；p<0.001，专家高频成分增加）。
结论
在模拟血管内神经放射学程序中，初学者和专家神经介入医生的 HRV 存在显著差异。专家的 HRV 降低，这可能是受试者在表现上付出努力的心血管替代指标。这与先前关于迷走神经对心脏和认知-执行表现影响的研究一致。
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