Pieper S J, Hammill S C
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, MN 55905, USA.
Mayo Clin Proc. 1995 Oct;70(10):955-64. doi: 10.4065/70.10.955.
To describe heart rate variability (HRV) analysis, especially time- and frequency-domain analyses, and some of its investigational applications in clinical cardiovascular medicine.
We provide a brief introduction to the magnitude of sudden cardiac death and the factors that influence life-threatening ventricular arrhythmias as a backdrop to the potential importance of the autonomic nervous system and how this system might be assessed by the analysis of HRV.
We reviewed the literature from 1973 to 1994 that described beat-to-beat changes in heart rate, heart rate signal recording and processing, and investigational applications of HRV analysis to cardiovascular medicine.
Beat-to-beat changes in heart rate are partly influenced by the autonomic nervous system. Briefly, changes in sympathetic input to the sinoatrial node affect low-frequency HRV, whereas changes in parasympathetic input affect high-frequency HRV. Multiple physiologic and nonphysiologic determinants of HRV exist, and therefore analysis of HRV as a direct "window" to autonomic tone is problematic.
In selected patient populations, analysis of HRV yields important information about sinoatrial responsiveness to autonomic input and mortality risk stratification. Routine application of HRV analysis to clinical cardiovascular medicine awaits further investigation, however.
描述心率变异性（HRV）分析，尤其是时域和频域分析，及其在临床心血管医学中的一些研究应用。
我们简要介绍心脏性猝死的规模以及影响危及生命的室性心律失常的因素，以此作为自主神经系统潜在重要性的背景，以及如何通过HRV分析来评估该系统。
我们回顾了1973年至1994年期间描述心率逐搏变化、心率信号记录与处理以及HRV分析在心血管医学中的研究应用的文献。
心率逐搏变化部分受自主神经系统影响。简而言之，对窦房结的交感神经输入变化影响低频HRV，而副交感神经输入变化影响高频HRV。HRV存在多种生理和非生理决定因素，因此将HRV分析作为自主神经张力的直接“窗口”存在问题。
在特定患者群体中，HRV分析可得出有关窦房结对自主神经输入的反应性以及死亡风险分层的重要信息。然而，HRV分析在临床心血管医学中的常规应用仍有待进一步研究。
