A composite autonomic index as unitary metric for heart rate variability: a proof of concept
A composite autonomic index as unitary metric for heart rate variability: a proof of concept
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DOI：
10.1111/eci.12730
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发表时间：
2017-03-01
影响因子：
5.5
通讯作者：
Lucini, Daniela
中科院分区：
文献类型：
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作者：
Sala, Roberto;Malacarne, Mara;Lucini, Daniela
背景 这项研究探讨了将心率变异性 (HRV) 的多个指标组合到雷达图中获得的单一心脏自主神经系统指数 (ANSI) 是否可以提供对临床环境中自主神经表现的简单评估。材料和方法使用来自相对较大的参考人群（n = 1593，年龄 39-13 岁）的自主神经代理的百分位排名对数据进行标准化。自主神经指数是通过静息和站立时 HRV（心电图衍生）的自回归频谱分析获得的。然后将简化的 ANSI（使用 RR、RR 方差和 LFnu 的静止差异）构建为雷达图，根据其组合面积进行量化，并针对不同的风险子组进行测试。结果随着风险状况的增加，ANSI 的排名值显着降低，通过雷达图面积单独量化。该方法的实际实用性在由额外受试者组成的小组中进行了测试，这些受试者的特征可能是自主神经性能提高或较差。数据显示，精英耐力运动员的特点是 ANSI 值升高（80.6 +/- 14.9，P < 0.001），而 1 型或 2 型糖尿病患者的 ANSI 值较低（DM1 = 37.0 +/- 18.9 和 DM2 = 26.8 +/- 23.3，P = 0.002），而冠状动脉疾病 (CAD) 患者代表最低值（17 +/- 20， P < 0.001）。结论这项观察性研究表明，在预防环境中测试基于多变量单一指数的更简单的心脏自主调节指标的可行性。这种简单的方法可能会促进 HRV 在临床领域的更广泛应用，并允许更容易地评估自主神经性能。
Background This study addresses whether a unitary cardiac autonomic nervous system index (ANSI), obtained combining multiple metrics from heart rate variability (HRV) into a radar plot could provide an easy appreciation of autonomic performance in a clinical setting.Materials and Methods Data are standardized using percentile ranking of autonomic proxies from a relatively large reference population (n = 1593, age 39 13 years). Autonomic indices are obtained from autoregressive spectral analysis of (ECG derived) HRV at rest and during standing up. A reduced ANSI (using RR, RR variance and rest-stand difference of LFnu) is then constructed as a radar plot, quantified according to its combined area and tested against different risk subgroups.Results With growing risk profile, there is a marked reduction of the rank value of ANSI, quantified individually by the radar plot area. The practical usefulness of the approach was tested in small groups of additional subjects putatively characterized by elevated or poor autonomic performance. Data show that elite endurance athletes are characterized by elevated values of ANSI (80.6 +/- 14.9, P < 0.001) while subjects with either Type 1 or Type 2 diabetes show lower values (DM1 = 37.0 +/- 18.9 and DM2 = 26.8 +/- 23.3, P = 0.002), and patients with coronary artery disease (CAD) represent a nadir (17 +/- 20, P < 0.001).Conclusions This observational study shows the feasibility of testing simpler metrics of cardiac autonomic regulation based on a multivariate unitary index in a preventive setting. This simple approach might foster a wider application of HRV in the clinical arena, and permit an easier appreciation of autonomic performance.