心率变异性与射血分数降低的心力衰竭：文献系统评价
Heart Rate Variability and Heart Failure with Reduced Ejection Fraction: A Systematic Review of Literature.
作者信息
Nagai Michiaki, Ewbank Hallum, Nakano Yukiko, Scherlag Benjamin J, Po Sunny S, Dasari Tarun W
机构信息
Cardiovascular Section, Department of Medicine, University of Oklahoma Health Science Center, Oklahoma, OK 73104, USA.
Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan.
出版信息
Curr Cardiol Rev. 2025;21(2):78-87. doi: 10.2174/011573403X327105241021180916.
INTRODUCTION
Autonomic impairment is a hallmark of heart failure with reduced ejection fraction (HFrEF). While there have been studies on general values for each index of heart rate variability (HRV) analysis in HFrEF, a systematic review comprehensively examining representative values in HFrEF is lacking.
METHODS
We searched PubMed, Embase, and Cochrane databases to extract studies reporting representative values of HRV metrics in HFrEF.
RESULTS
A total of 470 HFrEF patients from 6 studies were included in the review. In general, time and frequency domains were abnormally lower in HFrEF, portending a worse prognosis. In HFrEF, the mean or median value of the standard deviation of NN interval, root mean square successive difference, pNN50, and low-frequency power/high-frequency power were 40 to 121 msec, 19 to 62 msec, 1.3 to 14%, and 1.00 to 1.73, respectively.
CONCLUSION
In this systematic review, most HRV metrics were found to be calculated from 24- hour Holter recordings and were lower in HFrEF patients with poor prognosis.
引言
自主神经功能障碍是射血分数降低的心力衰竭（HFrEF）的一个标志。虽然已有关于HFrEF心率变异性（HRV）分析各指标一般值的研究，但缺乏全面检查HFrEF代表性值的系统评价。
方法
我们检索了PubMed、Embase和Cochrane数据库，以提取报告HFrEF中HRV指标代表性值的研究。
结果
该评价共纳入了来自6项研究的470例HFrEF患者。总体而言，HFrEF患者的时域和频域均异常降低，预示着预后较差。在HFrEF中，NN间期标准差、连续差值均方根、pNN50以及低频功率/高频功率的均值或中位数分别为40至121毫秒、19至62毫秒、1.3至14%以及1.00至1.73。
结论
在这项系统评价中，大多数HRV指标是根据24小时动态心电图记录计算得出的，且在预后较差的HFrEF患者中较低。
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