Heart rate variability and inflammation: A meta-analysis of human studies
Heart rate variability and inflammation: A meta-analysis of human studies
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DOI：
10.1016/j.bbi.2019.03.009
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发表时间：
2019-08-01
影响因子：
15.1
通讯作者：
Thayer, Julian F.
中科院分区：
文献类型：
--
作者：
Williams, DeWayne P.;Koenig, Julian;Thayer, Julian F.
炎症反射被认为是人体抵抗感染的主要防御手段，与许多疾病有关。炎症反应的强度很重要，因为极端或不充分的反应可能对个体造成不同程度的伤害。多种证据表明自主神经系统 (ANS) 调节炎症反射。心率变异性 (HRV) 可分为主要反映副交感神经 (PNS) 或迷走神经活动（即迷走神经介导的 HRV 指数）的组成部分以及交感神经 (SNS) 和 PNS 影响的组合。考虑到迷走神经和炎症过程之间的生理关系，人们预计会发现较高的 HRV，尤其是迷走神经介导的 HRV 指数，与通过胆碱能抗炎途径降低炎症水平有关。然而，现有的研究结果好坏参半，研究还表明 HRV 指数与炎症标志物之间存在正相关。因此，本荟萃分析旨在综合现有研究，估计HRV不同指标与炎症标志物之间关系的总体方向和强度。对文献进行系统检索，筛选出 2283 项研究纳入纳入资格（其中 159 项研究符合纳入资格）；总之，51 项研究报告/提供了纳入荟萃分析的充分信息。结果通常显示 HRV 指数与炎症标志物之间呈负相关。在这方面，与 HRV 的其他时域和频域测量相比，HRV 高频段 (HF-HRV) 的 R-R 间期 (SDNN) 和功率 (HF-HRV) 的标准差显示出与炎症标志物的最强和最稳健的关联。总体而言，我们建议 HRV 指数可用于索引负责适应性调节人类炎症过程的神经生理学通路的活动。
The inflammatory reflex is known as the body's primary defense against infection and has been implicated in a number of diseases. The magnitude of the inflammatory response is important, as an extreme or insufficient response can be differentially harmful to the individual. Converging evidence suggests that the autonomic nervous system (ANS) regulates the inflammatory reflex. Heart rate variability (HRV) can be separated into components that primarily reflect parasympathetic (PNS) or vagal activity (i.e., indices of vagally mediated HRV) and a combination of both sympathetic (SNS) and PNS influences. Given the physiological relation between the vagus and inflammatory processes, one would expect to find higher HRV, especially indices of vagally-mediated HRV, to be associated with decreased levels of inflammation via the cholinergic anti-inflammatory pathway. However, existing findings here are mixed, such that studies have also shown a positive association between indices of HRV and markers of inflammation. Therefore, the present meta-analysis aimed to synthesize existing studies, estimating the general direction and strength of the relationship between different indices of HRV and inflammatory markers. A systematic search of the literature yielded 2283 studies that were screened for inclusion eligibility (159 studies eligible for inclusion); in sum, 51 studies reported/provided adequate information for inclusion in meta-analyses. Results generally showed negative associations between indices of HRV and markers of inflammation. In this regard, the standard deviation of R-R intervals (SDNN) and power in the high frequency band of HRV (HF-HRV) showed the strongest and most robust associations with inflammatory markers compared to other time- and frequency-domain measures of HRV. Overall, we propose that indices of HRV can be used to index activity of the neurophysiological pathway responsible for adaptively regulating inflammatory processes in humans.