REPRODUCIBILITY AND RELATION TO MEAN HEART-RATE OF HEART-RATE-VARIABILITY IN NORMAL SUBJECTS AND IN PATIENTS WITH CONGESTIVE-HEART-FAILURE SECONDARY TO CORONARY-ARTERY DISEASE
REPRODUCIBILITY AND RELATION TO MEAN HEART-RATE OF HEART-RATE-VARIABILITY IN NORMAL SUBJECTS AND IN PATIENTS WITH CONGESTIVE-HEART-FAILURE SECONDARY TO CORONARY-ARTERY DISEASE
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DOI：
10.1016/0002-9149(91)90327-h
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发表时间：
1991-12-15
影响因子：
2.8
通讯作者：
SINGER, DH
中科院分区：
文献类型：
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作者：
VANHOOGENHUYZE, D;WEINSTEIN, N;SINGER, DH
在心率变异性可用于临床预测之前，需要将每日变异性和重复性定义为DO与平均心率的关系。因此，对33例正常人(年龄34+/-7岁，组I)和22例冠心病并稳定型充血性心力衰竭(CHF)患者(年龄59+/-7岁，组II)连续两次24小时动态心电图进行心率变异性和平均心率的测定。使用三个测量：(1)SDANN(24小时内连续5分钟记录周期内所有平均5分钟正常窦性RR间期的标准差)；(2)SD(24小时内连续5分钟记录周期内所有正常窦性RR间期标准差的平均值)；(3)CV(SD测量的变异系数)，一种补偿HR效应的新测量。II组的平均心率高于I组(80+/-10次/分对74+/-9次/分，p<；0.04)。第1天和第2天的心率和心率变异性的平均值具有良好的相关性(I组和II组的平均RR，r=0.89，0.97；SDANN，r=0.87，0.87；SD，r=0.93，0.97；CV，r=0.95，0.97)。相比之下，个体每天的差异很大(组I，0%到46%；组II，0%到51%)。低HR变异值比高HR变异值更一致。两组SDANN、SD与HR呈中度相关(r=0.5~0.64)。CV指标将人力资源对人力资源变异性的影响降至最低。总而言之，(1)正常人和CHF患者之间HR变异性的平均组间差异具有很高的重复性，但在某些受试者中可能会出现相当大的日常差异，特别是在HR变异性较高的正常人；(2)CHF患者的平均HR较高，而HR变异性较低；(3)在解释HR变异性的变化时，必须考虑平均HR。CV测量将此问题最小化。
Before heart rate (HR) variability can be used for predictive purposes in the clinical setting, day-to-day variation and reproducibility need to be defined as do relations to mean HR. HR variability and mean HR were therefore determined in 2 successive 24-hour ambulatory electrocardiograms obtained from 33 normal subjects (age 34 +/- 7 years, group I), and 22 patients with coronary disease and stable congestive heart failure (CHF) (age 59 +/- 7 years, group II). Three measures were used: (1) SDANN (standard deviation of all mean 5-minute normal sinus RR intervals in successive 5-minute recording periods over 24 hours); (2) SD (the mean of the standard deviation of al normal sinus RR intervals in successive 5-minute recording periods over 24 hours); and (3) CV (coefficient of variation of the SD measure), a new measure that compensates for HR effects. Group mean HR was higher and HR variability lower in group II than in group I (80 +/-10 vs 74 +/- 9 beats/min, p < 0.04). Mean group values for HR and HR variability showed good correlations between days 1 and 2 (mean RR, r = 0.89, 0.97; SDANN, r = 0.87, 0.87; SD, r = 0.93, 0.97; CV, r = 0.95, 0.97 in groups I and II, respectively). In contrast, considerable individual day-to-day variation occurred (group I, 0 to 46%; group II, 0 to 51%). Low HR variability values were more consistent than high values. SDANN and SD correlated moderately with HR in both groups (r = O.5O to 0.64). The CV measure minimizes HR effects on HR variability. In conclusion (1) mean group differences in HR variability between normal subjects and patients with CHF are highly reproducible, but considerable day-to-day variations may occur in some subjects, particularly normal persons with high HR variability; (2) mean HR is higher and HR variability lower in patients with CHF; and (3) mean HR must be considered when interpreting changes in HR variability. The CV measure minimizes this problem.