Siché J P, Longère P, Tremel F, de Gaudemaris R, Comparat V, Mallion J M
Service de médecine interne et cardiologie, CHU, Grenoble.
Arch Mal Coeur Vaiss. 1994 Aug;87(8):1023-7.
To study the relationship between spectral analysis measurement of blood pressure (BP) and heart rate (HR) at rest, in untreated essential hypertension, and their relationship with the development of left ventricular hypertrophy (LVH).
41 untreated hypertensives (25M/16W, age 50 +/- 12, range 23-73) were measured at rest (WHO criteria DBP > 90 mmHg) by digital continuous photoplethysmography (Finapres 2300 (F), 6 mn of measurement in the dorsal decubitus position and standing up). Measurement of LVH (Devereux criteria, left ventricular mass index LVMI, g/m2) to analyse two groups (LVMI+: LVMI > 107 if women and 120 if men; n = 19; LVMI = 137 +/- 25), and (LVMI-; n = 22; LVMI = 92 +/- 17). The overall variability is standard deviation (SD), spectral analysis variability (SA) is FFT of 256 points over 3 periods low (LF: 0.004-0.07Hz), medium (MF: 0.07-0.13Hz), high (HF: 0.13-0.5Hz). Comparisons by Wilcoxon test and Anova (age, sex) (* p < 0.05, ** p < 0.01).
By WHO criteria, the SBP was significantly lower in the LVMI-group (153 +/- 10 vs 165 +/- 18**), the DBP was not significantly different (94 +/- 6 vs 96 +/- 10). By continuous measure (F) at rest there was no significant difference for SBP or DBP. On standing up the SBP was significantly lower in the LVMI-group (148 +/- 20 vs 162 +/- 22**). The SD of the DBP at rest was more elevated in the LVMI-group (3.34 vs 3.06*), but not significantly different standing up. There was no significant difference in SBP at rest (6.7 vs 6.32) or standing (9.13 vs 11.5). The Spectral analysis of the MF was significantly elevated in the LVMI-group at rest for SBP (3.56 vs 3.01*), DBP (1.99 vs 1.19*), and HR (1.79 vs 1.77*). This was not significantly different in the LF and HF for SBP, DBP, HR.
These results are different from those obtained by invasive ambulatory measures. The spontaneous variability in BP and HR at rest is increased when there is no cardiac effect (LVMI-). SA gives additional information in showing that the increase in variability is due to an increase in the Mayer waves, suggesting the existence of an elevation in adrenergic tone in hypertensive patients not having LVH.
研究未经治疗的原发性高血压患者静息时血压（BP）和心率（HR）的频谱分析测量值之间的关系，以及它们与左心室肥厚（LVH）发展的关系。
对41例未经治疗的高血压患者（25例男性/16例女性，年龄50±12岁，范围23 - 73岁）进行静息测量（WHO标准：舒张压>90 mmHg），采用数字连续光电容积脉搏波描记法（Finapres 2300（F），在仰卧位和站立位测量6分钟）。测量LVH（Devereux标准，左心室质量指数LVMI，g/m²）以分析两组（LVMI +：女性LVMI>107，男性LVMI>120；n = 19；LVMI = 137±25）和（LVMI -；n = 22；LVMI = 92±17）。总体变异性为标准差（SD），频谱分析变异性（SA）是在3个时间段内对256个点进行快速傅里叶变换（FFT），低频（LF：0.004 - 0.07Hz）、中频（MF：0.07 - 0.13Hz）、高频（HF：0.13 - 0.5Hz）。采用Wilcoxon检验和方差分析（年龄、性别）进行比较（*p<0.05，**p<0.01）。
根据WHO标准，LVMI -组的收缩压（SBP）显著较低（153±10 vs 165±18**），舒张压（DBP）无显著差异（94±6 vs 96±10）。静息时通过连续测量（F），SBP或DBP无显著差异。站立时，LVMI -组的SBP显著较低（148±20 vs 162±22**）。LVMI -组静息时DBP的SD更高（3.34 vs 3.06*），但站立时无显著差异。静息时（6.7 vs 6.32）和站立时（9.13 vs 11.5）SBP无显著差异。LVMI -组静息时MF的频谱分析中，SBP（3.56 vs 3.01*）、DBP（1.99 vs 1.19*）和HR（1.79 vs 1.77*）显著升高。在LF和HF中，SBP、DBP、HR无显著差异。
这些结果与通过侵入性动态测量获得的结果不同。在无心脏影响（LVMI -）时，静息时BP和HR的自发变异性增加。频谱分析提供了额外信息，表明变异性增加是由于迈尔氏波增加，提示无LVH的高血压患者肾上腺素能张力升高。
