心理社会因素对心力衰竭患者自主神经系统活动的影响。
Effect of psychosocial factors on autonomic nervous system activity in patients with heart failure.
机构信息
Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
College of Nursing and Research Institute of Nursing Science, Ajou University, Suwon, Korea.
出版信息
Medicine (Baltimore). 2024 Mar 1;103(9):e37339. doi: 10.1097/MD.0000000000037339.
Autonomic imbalance predicts worse clinical outcomes in patients with heart failure (HF). Managing the variables affecting heart rate variability (HRV) might improve the clinical outcomes of patients with HF. This study aimed to investigate variables affecting HRV. We assessed autonomic nervous system activity (low-frequency [Lf], high-frequency [Hf], and Lf/Hf ratio) in 60 patients with HF, employing standard measures to capture short-term HRV. To estimate the independent effects of variables such as well-known cardiac risk factors and psychosocial conditions on HRV, multivariate analyses were conducted. For psychosocial variables, we assessed depression and quality of life in patients and their family caregivers. We also assessed the self-care behavior of patients and their caregivers' burden. Depression in family caregivers and self-care behavior of patients were independently associated with a decreased Hf (β-coefficient = 0.309, P = .039 and β-coefficient = -0.029, P = .047, respectively). Depression of family caregivers and self-care behavior of patients may affect HRV in patients with HF.
自主神经失衡可预测心力衰竭（HF）患者的临床预后较差。管理影响心率变异性（HRV）的变量可能会改善 HF 患者的临床结局。本研究旨在探讨影响 HRV 的变量。我们评估了 60 例 HF 患者的自主神经系统活动（低频 [Lf]、高频 [Hf] 和 Lf/Hf 比值），采用标准方法来捕捉短期 HRV。为了估计变量（如已知的心脏危险因素和社会心理状况）对 HRV 的独立影响，我们进行了多变量分析。对于社会心理变量，我们评估了患者及其家属照顾者的抑郁和生活质量。我们还评估了患者及其照顾者的自我护理行为的负担。家庭照顾者的抑郁和患者的自我护理行为与 Hf 降低独立相关（β系数分别为 0.309，P=0.039 和 β系数为-0.029，P=0.047）。家庭照顾者的抑郁和患者的自我护理行为可能会影响 HF 患者的 HRV。
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