Coarse graining spectral analysis of HR and BP variability in patients with autonomic failure
Coarse graining spectral analysis of HR and BP variability in patients with autonomic failure
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DOI：
10.1152/ajpheart.1996.271.4.h1555
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发表时间：
1996-10-01
影响因子：
4.8
通讯作者：
Freeman, R
中科院分区：
文献类型：
--
作者：
Blaber, AP;Bondar, RL;Freeman, R
我们检测了自主神经衰竭患者和年龄匹配对照者在不同倾斜（仰卧位、-10度、10度、30度、60度、-10度、仰卧位各5分钟）时的心率和血压变异性（HRV和BPV）。心率在患者和对照组之间没有差异，并随着倾斜而增加（P < 0.001）。患者总HRV降低（P < 0.03）。患者低频（0-0.15 Hz） HRV和BPV降低（P < 0.005）。随着倾斜，对照组的低频BPV增加，而患者的高频（>0.15 Hz） BPV增加。HRV和BPV分形分量（beta）的斜率在患者和对照组之间没有差异。hrv - β随倾斜度升高（1.5 ~ 1.9,P < 0.01）， bpv - β不受影响（与1.8相似）。当beta值接近1时，表示信号调节复杂度高，当beta值接近2时，表示信号调节复杂度低。HRV和BPV提供了交感和副交感自主神经系统对倾斜和自主神经衰竭反应受损的明确证据。与对照组相比，患者信号复杂性与分形和谐波频谱功率降低的相似性表明，自主神经衰竭时心血管神经输入和整合不变，输出减少。
We examined heart rate and blood pressure variability (HRV and BPV) during graded tilt (5 min in each position: supine, -10 degrees, 10 degrees, 30 degrees, 60 degrees, -10 degrees, supine) in autonomic failure patients and age-matched controls. Heart rate was not different between patients and controls and increased with tilt (P < 0.001). Total HRV was reduced in patients (P < 0.03). Patients had reduced low-frequency (0-0.15 Hz) HRV and BPV (P < 0.005). With tilt, low-frequency BPV increased in controls, whereas high-frequency (>0.15 Hz) BPV increased in patients. The slope of the fractal component (beta) for HRV and BPV was not different between patients and controls. HRV-beta increased (1.5-1.9, P < 0.01) with tilt, but BPV-beta (similar to 1.8) was unaffected. Values of beta close to 1 indicate high signal regulatory complexity, and values of beta close to 2 indicate low complexity. HRV and BPV provide clear evidence of impaired sympathetic and parasympathetic autonomic nervous system response to tilt with autonomic failure. The similarity in signal complexity with reduced fractal and harmonic spectral power, in patients compared with controls, suggests unchanged cardiovascular neural input and integration with reduced output in autonomic failure.