Essibayi Muhammed Amir, Toma Aureliana, Mowrey Wenzhu, Qin Jiyue, Hamad Mousa, Ryvlin Jessica, Holland Ryan, Fluss Rose, Altschul Dorothea, Lin Li-Mei, Altschul David J
Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Interv Neuroradiol. 2025 Apr;31(2):235-240. doi: 10.1177/15910199231162472. Epub 2023 Mar 22.
IntroductionHeart rate variability (HRV) reflects the activity of the autonomic nervous system (ANS) and can be used as a potential predictor of stress-related cardiovascular diseases. This study aimed to assess whether physical and mental strain during the performance of cerebral endovascular procedure influence time-domain HRV parameters in operating surgeon.Materials and MethodsHeart rate (HR) and HRV metrics were measured using a HR sensor chest strap before, during, and after neuroendovascular interventions performed by a single neurosurgeon. Three consecutive data series were reported by recording time domain: before procedure, during and after performing endovascular procedures. HR and HRV parameters were recorded during diagnostic and interventional neuroendovascular procedures. HR and HRV measures were analyzed by procedure type and recording time domain.ResultsHRV measures of a single endovascular neurosurgeon were recorded during 50 procedures. The median intraprocedural HRV score was the lowest and the median HR was the highest (HRV: 52, HR: 89 bpm) compared to preprocedural (HRV: 59, HR: 70 bpm) and postprocedural cardiovascular measures (HRV: 53, HR: 79, bpm, < 0.001). On univariate linear regression, a negative association of interventional procedures with lower intraprocedural (β = -0.905, = 0.001) and postprocedural (β = -1.12, < 0.001) HRV scores compared to the diagnostic procedures was noted.ConclusionsHRV is a reliable tool to measure cardiovascular and mental stress. Interventional neuro-endovascular procedures seem to negatively impact the cardiovascular measures of neurointerventionalists. Further longitudinal studies utilizing HRV are warranted to address their long-term effects on the mental health of physicians.
引言
心率变异性（HRV）反映自主神经系统（ANS）的活动，可作为应激相关心血管疾病的潜在预测指标。本研究旨在评估脑血管内介入手术过程中的身心压力是否会影响手术医生的时域HRV参数。
材料与方法
使用心率传感器胸带，在一位神经外科医生进行神经血管内介入手术前、手术期间和手术后测量心率（HR）和HRV指标。通过记录时域报告三个连续的数据系列：手术前、血管内手术进行期间和手术后。在诊断性和介入性神经血管内手术期间记录HR和HRV参数。根据手术类型和记录时域分析HR和HRV测量值。
结果
在50例手术中记录了一位血管内神经外科医生的HRV测量值。与术前（HRV：59，HR：70次/分钟）和术后心血管测量值（HRV：53，HR：79次/分钟，P<0.001）相比，术中HRV评分中位数最低，HR中位数最高（HRV：52，HR：89次/分钟）。在单变量线性回归中，与诊断性手术相比，介入性手术与术中较低的HRV评分（β=-0.905，P=0.001）和术后HRV评分（β=-1.12，P<0.001）呈负相关。
结论
HRV是测量心血管和精神压力的可靠工具。介入性神经血管内手术似乎会对神经介入医生的心血管指标产生负面影响。有必要进行进一步的纵向研究，利用HRV来探讨其对医生心理健康的长期影响。
