Kinoshita O, Hongo M, Saikawa Y, Katsuyama T, Tanaka M, Takeda M, Yamamoto H, Isobe M, Sekiguchi M
First Department of Internal Medicine, Shinshu University, Marunouchi Hospital, Matsumoto City, Japan.
Pacing Clin Electrophysiol. 1997 Dec;20(12 Pt 1):2949-53. doi: 10.1111/j.1540-8159.1997.tb05465.x.
The purpose of this study was to evaluate heart rate variability (HRV) in patients with familial amyloid polyneuropathy (FAP) using the time- and frequency-domain analysis. The study population consisted of 19 patients with FAP, and 19 age and sex matched normal volunteers. The 24-hour Holter recordings of all subjects in sinus rhythm and off medication were analyzed. Five time-domain indices of HRV were computed. The frequency component of HRV was calculated by fast Fourier transform analysis of the RR intervals. The power spectrum of the low frequency (LF) between 0.04-0.15 Hz and high frequency (HF) between 0.15-0.40 Hz and the LF/HF ratio was calculated. Global measures of HRV including the standard deviation of the mean of RR intervals (SDNN) and the standard deviation of 5-minute mean RR intervals (SDANN) were decreased in patients with FAP. Specific vagal influences on HRV including the proportion of RR intervals more than 50 milliseconds different (pNN50) and the HF power on spectral analysis were less in patients with FAP. LF power and LF/HF ratio were more decreased in patients with FAP at the advanced stage than at the early stage. In conclusion, HRV was significantly decreased in patients with FAP at the early stage, and sympathetic activity was more decreased in patients at the advanced stage. These findings suggest that the decrease of the HRV is an indicator of this disease and the power spectral analysis of the HRV is beneficial in assessing the severity of the autonomic dysfunction.
本研究的目的是使用时域和频域分析评估家族性淀粉样多神经病（FAP）患者的心率变异性（HRV）。研究对象包括19例FAP患者以及19名年龄和性别匹配的正常志愿者。对所有处于窦性心律且未服用药物的受试者进行24小时动态心电图记录分析。计算了HRV的五个时域指标。通过对RR间期进行快速傅里叶变换分析来计算HRV的频率成分。计算了0.04 - 0.15Hz之间的低频（LF）功率谱、0.15 - 0.40Hz之间的高频（HF）功率谱以及LF/HF比值。FAP患者的HRV整体测量指标，包括RR间期均值的标准差（SDNN）和5分钟RR间期均值的标准差（SDANN）均降低。FAP患者中，对HRV的特定迷走神经影响，包括RR间期相差超过50毫秒的比例（pNN50）以及频谱分析中的HF功率均降低。FAP晚期患者的LF功率和LF/HF比值较早期患者下降更明显。总之，FAP早期患者的HRV显著降低，晚期患者的交感神经活动下降更明显。这些发现表明，HRV降低是该疾病的一个指标，并且HRV的功率谱分析有助于评估自主神经功能障碍的严重程度。
