Gibelin P
Service de cardiologie, CHU Pasteur, Nice.
Arch Mal Coeur Vaiss. 1998 Dec;91(12 Suppl):15-8.
Analysis of heart rate variability is an attractive, non-invasive method for studying the cardiac response to stimulation by the autonomic nervous system which is decreased in chronic cardiac failure. The prognostic value of heart rate variability in cardiac failure has been the subject of recent research. The 24-hour standard deviation is the commonest parameter with an independent predictive value for mortality. However, its threshold value is variable according to the different studies. The percentage of successive RR intervals varying by more than 50 ms is a sign of parasympathetic activity and is not found to be an independent prognostic factor by all workers. The results of values of low frequency on spectral analysis are contradictory. Finally, the Poincaré graphic method showing an abnormal graph is one of the only predictive factors of sudden death. Blood pressure variability will probably complete the analysis of heart rate variability as a prognostic factor of chronic heart failure.
心率变异性分析是一种用于研究自主神经系统刺激下心脏反应的有吸引力的非侵入性方法,而慢性心力衰竭时自主神经系统刺激下的心脏反应会减弱。心力衰竭中心率变异性的预后价值一直是近期研究的主题。24小时标准差是最常见的具有独立预测死亡率价值的参数。然而,根据不同研究,其阈值有所不同。连续RR间期变化超过50毫秒的百分比是副交感神经活动的标志,但并非所有研究人员都发现它是一个独立的预后因素。频谱分析中低频值的结果相互矛盾。最后,显示图形异常的庞加莱图法是猝死的唯一预测因素之一。血压变异性可能会作为慢性心力衰竭的预后因素完善心率变异性分析。