Yoshida Yuto, Takei Hinako, Ukisu Misaki, Takagi Keigo, Tanito Masaki
Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo 693-8501, Japan.
Biomedicines. 2025 Sep 4;13(9):2155. doi: 10.3390/biomedicines13092155.
: Autonomic nervous system (ANS) and vascular factors are associated with glaucoma. However, the association between systemic comorbidity burden and ANS and hemodynamic function in patients with glaucoma remains unclear. This study aimed to examine the association between heart rate variability (HRV) and acceleration plethysmography (APG) parameters and the age-adjusted Charlson Comorbidity Index (ACCI) in patients with glaucoma. : A total of 260 subjects (260 eyes), including 186 with primary open-angle glaucoma (PG) and 74 with exfoliation glaucoma (EG), were enrolled at Shimane University Hospital from June 2023 to July 2024. HRV and APG were assessed using a sphygmograph (TAS9 Pulse Analyzer Plus View). HRV parameters included time-domain measures (SDNN, RMSSD, CVRR) and frequency-domain measures (TP, VLF, LF, HF, LF/HF). APG parameters included the a, b, c, d, and e components of the accelerated pulse wave, and the following vascular types: Type A, Type B, and Type C. The association between ACCI and HRV and APG parameters was evaluated using Spearman's rank correlation and multivariate regression adjusted for sex, body mass index, pulse rate, systolic and diastolic blood pressure, intraocular pressure, medication score, mean deviation, and glaucoma type. : By univariate analysis, against ACCI, significant inverse correlations were observed for several parameters: LnLF (R = -0.17, = 0.0062); LnLF/LnHF (R = -0.24, = 0.00012); b peak (R = -0.14, = 0.031); d peak (R = -0.17, = 0.0072); and e peak (R = -0.15, = 0.015). Regarding HRV parameters, multivariate linear regression models showed that ACCI was significantly positively associated with RMSSD (coefficient: 2.861; 95% CI: 0.447 to 5.274) and significantly negatively associated with the frequency-domain parameters LnLF (coefficient: -0.127; 95% CI: -0.245 to -0.009) and LnLF/LnHF (coefficient: -0.038; 95% CI: -0.062 to -0.014). In APG parameters, the c peak was significant associated with ACCI (coefficient: -12.6; 95% CI: -22.5 to -2.69). ACCI was significantly associated with Type B (coefficient: 0.305; 95% CI: 0.057 to 0.552). : Greater systemic comorbidity burden may be related to impaired ANS regulation and increased vascular stiffness in glaucoma patients.
自主神经系统（ANS）和血管因素与青光眼有关。然而，青光眼患者全身合并症负担与ANS及血流动力学功能之间的关联仍不清楚。本研究旨在探讨青光眼患者心率变异性（HRV）和加速度体积描记法（APG）参数与年龄校正的查尔森合并症指数（ACCI）之间的关联。
2023年6月至2024年7月，共有260名受试者（260只眼）在岛根大学医院入组，其中186例原发性开角型青光眼（PG）患者和74例剥脱性青光眼（EG）患者。使用脉搏记录仪（TAS9 Pulse Analyzer Plus View）评估HRV和APG。HRV参数包括时域测量值（SDNN、RMSSD、CVRR）和频域测量值（TP、VLF、LF、HF、LF/HF）。APG参数包括加速脉搏波的a、b、c、d和e成分，以及以下血管类型：A型、B型和C型。使用Spearman等级相关性和针对性别、体重指数、脉搏率、收缩压和舒张压、眼压、用药评分、平均偏差和青光眼类型进行校正的多变量回归评估ACCI与HRV和APG参数之间的关联。
单变量分析显示，与ACCI相比，几个参数存在显著负相关：LnLF（R = -0.17，P = 0.0062）；LnLF/LnHF（R = -0.24，P = 0.00012）；b波峰（R = -0.14，P = 0.031）；d波峰（R = -0.17，P = 0.0072）；以及e波峰（R = -0.
