Malik M
Department of Cardiological Sciences, St. George's Hospital Medical School, London, UK.
Curr Opin Cardiol. 1998 Jan;13(1):36-44. doi: 10.1097/00001573-199801000-00006.
Heart rate variability is a recognized tool for the estimation of cardiac autonomic modulations. Recently, several studies have advanced the field of heart rate variability in three areas: 1) in technical modes of electrocardiogram processing and heart rate variability assessment, 2) in physiologic understanding and interpretation, and 3) in clinical and practical use. The most recent technical studies concentrate on the analysis of nonlinear aspects of heart period variations and on coherence between electrocardiogram variability and other physiologic factors such as respiration. Principal physiologic investigations studied the components of heart rate variability attributable to the individual limbs of the autonomic nervous system. It is becoming recognized that behavior and responses to the environment, including the psychosocial environment, play an important role in long-term heart rate variability. Established clinical applications of heart rate variability are presently restricted to the assessment of risk after myocardial infarction and to the early diagnosis of diabetic neuropathy. Nevertheless, recent studies indicate that heart rate variability might soon become a similarly powerful tool for risk prediction and monitoring of disease progression in congestive heart failure and for monitoring or reinnervation after heart transplantation.
心率变异性是评估心脏自主神经调节的一种公认工具。最近，多项研究在三个领域推动了心率变异性的发展：1）心电图处理和心率变异性评估的技术模式；2）生理理解与解释；3）临床及实际应用。最新的技术研究集中在心动周期变化的非线性方面分析以及心电图变异性与呼吸等其他生理因素之间的相关性。主要的生理学研究探讨了自主神经系统各分支对心率变异性的影响因素。人们逐渐认识到，行为以及对包括心理社会环境在内的环境的反应，在长期心率变异性中起着重要作用。心率变异性目前已确立的临床应用仅限于评估心肌梗死后的风险以及糖尿病神经病变的早期诊断。然而，最近的研究表明，心率变异性可能很快成为预测充血性心力衰竭风险和监测疾病进展以及监测心脏移植后神经再生的同样强大的工具。
