Istituti Clinici Scientifici Maugeri IRCCS, Via Camaldoli 64, 20138, Milano, Italy.
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Clin Auton Res. 2023 Dec;33(6):821-841. doi: 10.1007/s10286-023-00969-3. Epub 2023 Aug 4.
Increasing evidence demonstrates that gender-related factors, and not only biological sex, are relevant in the physiological and pathophysiological mechanisms of the cardiovascular system, including the cardiac autonomic regulation. Sex and gender may also affect daytime and night-time cardiac autonomic control. This meta-analysis aimed to provide a comparison between healthy women and men on heart rate variability using 24-h ECG recordings pointing out sex- and gender-related factors.
A systematic search was conducted to include studies focusing on both sex and gender differences related to heart rate variability indices in the time and frequency domains. Descriptive data were extracted by two independent reviewers. For each index, standardized mean differences with 95% confidence intervals were computed and a pooled estimate using a fixed- or random-effects model was applied.
Twenty-seven studies were included in the meta-analysis. The results showed that only seven studies reported some information about gender-related factors. Concerning sex-related differences, women had a shorter mean RR interval and lower variability of the time domain indices than men. Sex-related differences concerning frequency domain indices were more evident during night-time compared to daytime.
The characterization of gender-related factors in the study of heart rate variability using 24-h ECG recordings is still sporadic and underexplored. The meta-analysis results could not conclusively support a significant increase of high frequency power in women, although women showed a reduced total power and low frequency to high frequency ratio. There is a strong need for considering heart rate variability in relation to gender-related variables.
越来越多的证据表明，性别相关因素，而不仅仅是生物学性别，与心血管系统的生理和病理生理机制有关，包括心脏自主调节。性别也可能影响白天和夜间的心脏自主控制。本荟萃分析旨在比较 24 小时心电图记录中健康女性和男性的心率变异性，指出与性别相关的因素。
进行了系统搜索，以纳入关注时间和频率域中心率变异性指数的性别和性别差异的研究。两名独立评审员提取描述性数据。对于每个指数，计算了标准化均数差和 95%置信区间，并应用固定或随机效应模型进行汇总估计。
荟萃分析纳入了 27 项研究。结果表明，只有 7 项研究报告了一些与性别相关因素有关的信息。关于性别相关差异，女性的平均 RR 间期较短，时域指数的变异性较低。与频域指数相关的性别差异在夜间比白天更为明显。
使用 24 小时心电图记录研究心率变异性时，对性别相关因素的描述仍然零星且探索不足。荟萃分析结果不能明确支持女性高频功率显著增加，尽管女性的总功率降低，低频与高频比值降低。强烈需要考虑与性别相关变量有关的心率变异性。
