Coumel P, Maison-Blanche P, Catuli D
Hôpital Lariboisière, Paris, France.
J Cardiovasc Electrophysiol. 1994 Nov;5(11):899-911. doi: 10.1111/j.1540-8167.1994.tb01130.x.
The relationships between heart rate (HR) and HR variability (HRV) are not simple. Because both depend on the autonomic nervous system (ANS), they are not independent variables. Technically, the quantification of HRV is influenced by the duration of the cardiac cycles. The complexity of these relationships does not justify ignoring HR when studying HRV, as frequently occurs.
Using spectral and nonspectral methods, the HR and various normalized and non-normalized indices of HRV were studied in 24-hour recordings of a homogeneous cohort of seventeen 20-year-old healthy males. The HR-HRV relationships were appraised by analyzing the same data in two different ways. The 24 mean hourly values provide consistent information on the circadian behavior of the indices, while the average 24-hour individual data show a wide spectrum of normality. Combined approaches allow assessment of the direct impact of RR interval on HRV evaluation. The correlations between HR and normalized indices of HRV are weaker in 24-hour individual data than in pooled hourly data of the same individuals. These correlations are close to 1 in the latter case, which does not mean that measuring HRV is simply another method of evaluating HR, but that normal physiology supposes a harmonious behavior of the various indices. When considered individually without normalization, the specific indices of vagal modulation (high-frequency band of the spectrum, short-term HR oscillations of the nonspectral analysis) consistently increase at night and diminish during the day. However, the low-frequency power, which supposedly reflects sympathetic influences, also increases at night, whereas more logically the longer HR oscillations would predominate during the day. Moreover, the selective analysis of HR oscillations during HR acceleration or decrease indicates that their behavior differs accordingly.
We recommend that closer attention be paid to the complex relationships between HR and HRV. The strong correlations found in healthy subjects may reflect either the physiological harmony of ANS functions or simple redundancy. Their tendency to deteriorate in diseased hearts suggests that redundancy is not the cause and that abnormalities of ANS functions are not demonstrated by HRV analysis alone.
心率(HR)与心率变异性(HRV)之间的关系并不简单。由于两者都依赖于自主神经系统(ANS),它们并非独立变量。从技术上讲,HRV的量化受心动周期时长的影响。这些关系的复杂性并不能成为在研究HRV时如经常出现的那样忽略HR的理由。
使用频谱和非频谱方法,在17名20岁健康男性的同质队列的24小时记录中研究了HR以及HRV的各种标准化和非标准化指标。通过两种不同方式分析相同数据来评估HR-HRV关系。24个每小时的均值提供了关于这些指标昼夜行为的一致信息,而24小时个体平均数据显示出广泛的正常范围。综合方法允许评估RR间期对HRV评估的直接影响。在24小时个体数据中,HR与HRV标准化指标之间的相关性比相同个体的每小时汇总数据中的相关性弱。在后一种情况下,这些相关性接近1,这并不意味着测量HRV仅仅是评估HR的另一种方法,而是正常生理状态假定各种指标具有协调的行为。当单独考虑未标准化的情况时,迷走神经调制的特定指标(频谱的高频带、非频谱分析中的短期HR振荡)在夜间持续增加而在白天减少。然而,据推测反映交感神经影响的低频功率在夜间也增加,而从逻辑上讲,较长的HR振荡在白天应该占主导。此外,对HR加速或减速期间HR振荡的选择性分析表明它们的行为相应不同。
我们建议更加关注HR与HRV之间的复杂关系。在健康受试者中发现的强相关性可能反映了ANS功能的生理协调性或仅仅是冗余性。它们在患病心脏中恶化的趋势表明冗余性并非原因,并且ANS功能异常不能仅通过HRV分析来证明。