Factors influencing heart rate variability power spectral analysis during controlled breathing in patients with chronic heart failure or hypertension and in healthy normotensive subjects
Factors influencing heart rate variability power spectral analysis during controlled breathing in patients with chronic heart failure or hypertension and in healthy normotensive subjects
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DOI：
10.1042/cs20030401
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发表时间：
2004-08-01
期刊：
影响因子：
6
通讯作者：
Nocco, M
中科院分区：
文献类型：
--
作者：
Piccirillo, G;Magrì, D;Nocco, M
HRV [HR（心率）变异性] 的 UP（低频功率）频谱成分降低是 CHF（慢性心力衰竭）患者猝死的危险因素。在本研究中，我们评估了 CHF 或高血压患者以及健康正常血压受试者受控呼吸期间短期记录中影响 UP 和 HFP（高频功率）分量的因素（年龄、动脉压和 HR）。在 CHF 患者中，我们还将 UP 值与已知的猝死标志物 [NYHA（纽约心脏协会）分级、HR 和射血分数] 进行了比较。 CHF 患者的所有 HRV 指标均显着低于高血压和血压正常受试者 (P < 0.001)，而高血压患者则显着低于血压正常受试者 (P < 0.05)。逐步多元回归分析显示，CHF患者的LFP与NYHA分级（β=-0.5，P<0.0001）和HR（β=-0.2，P=0.001）呈负相关，与射血分数呈正相关（β=0.28，P<0.0001）。在 CHF 患者中，UP 随年龄变化保持不变。在血压正常和高血压受试者中，HFP 随着年龄的增长而下降，但在 CHF 患者中却没有。在大于或等于 60 < 70 岁和大于或等于 70 岁的亚组中，我们发现所研究的三个组中的 HFP 之间没有差异。因此，在血压正常和高血压患者中，LFP往往随着年龄的增长而降低（血压正常者β = -0.4，P < 0.0001；高血压者β = -0.4，P < 0.001），并且与HR呈负相关（血压正常者β = -0.2，P = 0.002；高血压者β = -0.3，P = 0.002）。相反，在 CHF 患者中，LFP 主要受 NYHA 分级、HR 和射血分数影响，但不受年龄影响。因此，LFP 可能会提高已用于对 CHF 患者猝死风险进行分层的因素的敏感性。
A decreased UP (low-frequency power) spectral component of HRV [HR (heart rate) variability] is a risk factor for sudden death in patients with CHF (chronic heart failure). In the present study, we evaluated factors (age, arterial pressures and HR) influencing UP and HFP (high-frequency power) components in short-term recordings during controlled breathing in patients with CHF or hypertension, and healthy normotensive subjects. In patients with CHF we also compared UP values with known markers of sudden death [NYHA (New York Heart Association) class, HR and ejection fraction]. All HRV measures were significantly lower in patients with CHF than in hypertensive and normotensive subjects (P < 0.001), and in hypertensive than in normotensive subjects (P < 0.05). Stepwise multiple regression analysis showed that, in patients with CHF, LFP was inversely associated with NYHA class (beta = -0.5, P < 0.0001) and HR (beta = -0.2, P = 0.001) and was positively associated with ejection fraction (beta = 0.28, P < 0.0001). In patients with CHF, UP remained unchanged with age. In normotensive and hypertensive subjects, HFP decreased with age, but in patients with CHF it did not. In the greater than or equal to 60 < 70 and greater than or equal to 70 years of age subgroups, we found no difference between HFP in the three groups studied. Hence, in normotensives and hypertensives, LFP tended to diminish with age (beta = -0.4, P < 0.0001 in normotensives; beta = -0.4, P < 0.001 in hypertensives) and was inversely associated with HR (beta= -0.2, P = 0.002 in normotensives; beta = -0.3, P = 0.002 in hypertensives). Conversely, in patients with CHF, LFP is predominantly influenced by NYHA class, HR and ejection fraction, but not by age. LFP might therefore increase the sensitivity of factors already used in stratifying the risk of sudden death in patients with CHF.