Blood Pressure and Heart Rate Variability in Primary Open-Angle Glaucoma and Normal Tension Glaucoma
Blood Pressure and Heart Rate Variability in Primary Open-Angle Glaucoma and Normal Tension Glaucoma
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DOI：
10.1080/02713683.2018.1506036
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发表时间：
2018-12-02
影响因子：
2
通讯作者：
Plange, Niklas
中科院分区：
文献类型：
--
作者：
Lindemann, Friederike;Kuerten, David;Plange, Niklas
目的：血管功能障碍和缺血被认为在青光眼尤其是正常眼压性青光眼（NTG）的发病机制中起重要作用。本研究的目的是分析原发性开角型青光眼（POAG）和NTG患者与对照组相比的血压（BP）和心率变异性模式。方法：共有37例POAG患者，27例NTG患者和82例对照者被纳入前瞻性临床验证研究。在静息条件下，在30 min内同时记录连续BP和心率（Glaucoscreen，aviant GmbH，Jena，德国）。提取心率、收缩压（SBP）和舒张压（DBP）的时间序列并进行分析，计算单变量线性（时域、频域）、非线性（符号动力学）和双变量（联合符号动力学）指标。结果如下：总的来说，12个参数可以确定为POAG患者和对照组相比，有显着差异，而80个参数在NTG患者与对照组相比，有显着差异。由三个指标组成的最佳组合显示NTG患者的敏感性为81.5%，特异性为86.6%，POAG患者的敏感性为62.2%，特异性为82.9%。结论：血压变异性的改变以及与心率的耦合表明青光眼患者的自主心血管调节模式受损，尤其是NTG患者。
Purpose: Vascular dysfunction and ischemia are believed to play an important part in the pathogenesis of glaucoma and especially of normal tension glaucoma (NTG). The aim of the present study was to analyze the blood pressure (BP) and heart rate variability patterns in patients with primary open-angle glaucoma (POAG) and NTG compared with controls. Methods: In total, 37 patients with POAG, 27 patients with NTG, and 82 control subjects were included in a prospective clinical validation study. Continuous BP and heart rate were simultaneously recorded over 30 min (Glaucoscreen, aviant GmbH, Jena, Germany) under resting conditions. Time series of heart rate, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were extracted and analyzed calculating univariate linear (time domain, frequency domain), nonlinear (symbolic dynamics), and bivariate (joint symbolic dynamics) indices. Results: Overall, 12 parameters could be identified that were significantly different when comparing POAG patients and controls, whereas 80 parameters were significantly different in NTG patients compared with controls. The optimum set consisting of three indices showed a sensitivity of 81.5% at a specificity of 86.6% for NTG patients compared with a sensitivity of 62.2% at a specificity of 82.9% for POAG patients. Conclusions: Alterations in BP variability and coupling with heart rate suggest impaired patterns of autonomic cardiovascular regulation in glaucoma patients especially in patients with NTG.