Symbolic dynamics of heart rate variability - A probe to investigate cardiac autonomic modulation
Symbolic dynamics of heart rate variability - A probe to investigate cardiac autonomic modulation
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DOI：
10.1161/circulationaha.104.518449
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发表时间：
2005-07-26
期刊：
影响因子：
37.8
通讯作者：
Porta, A
中科院分区：
文献类型：
--
作者：
Guzzetti, S;Borroni, E;Porta, A
背景-交感和副交感神经系统被认为是控制心率的主要快速反应系统。方法和结果-我们提出了一个象征性的分析系列来量化交感或副交感心脏调节的患病率。该分析将心率变异性序列分解为持续3次心跳的模式，并将其分为3类：无变量、可变和非常可变的模式，即0V、1V和2V模式。首先，我们将该方法应用于60名健康受试者的实验和药理学条件，包括交感神经激活（倾斜试验、握力、硝普苷和高剂量阿托品）或副交感神经激活（苯肾上腺素和低剂量阿托品）。交感调节的增加和迷走神经的戒断引起了0V模式的显著增加和2V模式的减少，而副交感神经的支配则引起了相反的结果，反映了相互的交感-病-迷走神经平衡。研究的第二部分考虑了植入心律转复除颤器的患者在主要心律失常事件发生前的一系列300次跳动。符号分析发现，与基线相比，在主要心律失常发作前0V模式的百分比增加（分别为41.6 +/- 3.9%和24.4 +/- 2.9%,P < 0.01），表明交感神经流行。另一方面，在严重心律失常之前，2V模式并没有减少，这表明存在非互反的自主神经调节。结论：3次心跳序列的符号分析考虑了交感和副交感心脏调节的不同时间过程，似乎适合阐明急性心脏事件发生前短时间内发生的神经病理生理机制。
Background - Sympathetic and parasympathetic systems are considered the principal rapidly reacting systems that control heart rate.Methods and Results - We propose a symbolic analysis series to quantify the prevalence of sympathetic or parasympathetic cardiac modulation. This analysis decomposes the heart rate variability series in patterns lasting 3 beats and classifies them into 3 categories: nonvariable, variable, and very variable patterns referred to as 0V, 1V, and 2V patterns. First, we applied this method to experimental and pharmacological conditions characterized by sympathetic activation (tilt test, handgrip, nitroprusside, and high-dose atropine administration) or parasympathetic activation (phenylephrine and low-dose atropine administration) in 60 healthy subjects. An increase in sympathetic modulation and a vagal withdrawal elicited a significant increase in 0V patterns and a decrease in 2V patterns, whereas parasympathetic dominance induced the opposite, reflecting a reciprocal sympathovagal balance. The second part of the study considered a series of 300 beats before the onset of major arrhythmic events in patients with an implantable cardioverter-defibrillator. Symbolic analysis detected an increase in the percentage of 0V patterns before the onset of major arrhythmias compared with baseline (41.6 +/- 3.9% and 24.4 +/- 2.9%, respectively; P < 0.01), indicating a sympathetic prevalence. On the other hand, the 2V patterns did not decrease before major arrhythmias, suggesting the presence of nonreciprocal autonomic modulations.Conclusions - Symbolic analysis of 3 beat sequences takes into account the different time course of sympathetic and parasympathetic cardiac modulations and seems appropriate for elucidating the neural pathophysiological mechanisms occurring during the short periods that precede acute cardiac events.