Respiratory sinus arrhythmia, cardiac vagal control, and daily activity
Respiratory sinus arrhythmia, cardiac vagal control, and daily activity
复制标题
DOI：
10.1152/ajpheart.00825.2003
复制
发表时间：
2004-08-01
影响因子：
4.8
通讯作者：
Spoerle, M
中科院分区：
文献类型：
--
作者：
Grossman, P;Wilhelm, FH;Spoerle, M
动态呼吸性窦性心律失常（RSA）或高频心率（HR）变异经常被用作心脏副交感神经控制的指标，并且与心血管疾病的风险或严重程度相关。然而，实验室研究表明，体力活动以及速率和潮气量的呼吸参数的变化可能会混淆迷走神经活动的估计。由于实验室外对这些关系知之甚少，因此我们通过采用多通道监测系统检查了清醒时 RSA、呼吸、体力活动和 HR 之间的动态关系。四十名健康的青壮年成年人接受了白天监测，包括连续记录心电图、呼吸（电感体积描记法）和加速度测量运动活动。进行个体内回归分析以检查 RSA 与呼吸、HR 和体力活动指数（每分钟通气量和运动）之间的每分钟关系。心率变化被认为与个体内迷走神经张力的变化密切相关。比较根据呼吸参数调整的 RSA 和未调整的 RSA 的其他测量值的预测强度。未调整的 RSA 与呼吸参数 (R = 0.80) 以及适度预测的每分钟 HR 和活动方差相关（平均值 = 56%，HR；48%，每分钟通气量；37%，运动）。调整后的 RSA 预测 HR 和活动方差显着更大（平均值分别为 75%、76% 和 57%），且置信区间更窄。我们得出结论，动态 RSA 大小与呼吸变化和体力活动有关。呼吸参数的调整大大改善了 RSA 与显着迷走神经介导的 HR 和体力活动之间的关系。同时监测呼吸和身体活动可以提高心率变异性的准确性，以预测自主控制。
Ambulatory respiratory sinus arrhythmia (RSA) or high-frequency heart rate (HR) variability is frequently employed as an index of cardiac parasympathetic control and related to risk or severity of cardiovascular disease. However, laboratory studies indicate variations in physical activity and respiratory parameters of rate and tidal volume may confound estimation of vagal activity. Because little is known about these relations outside the laboratory, we examined ambulatory relations among RSA, respiration, physical activity, and HR during waking hours by employing a multichannel monitoring system. Forty healthy young-to-middle aged adults underwent daytime monitoring that included continuous registration of the ECG, respiration (inductance plethysmography), and accelerometry motion activity. Within-individual regression analyses were performed to examine minute-to-minute relations between RSA and respiration, HR, and indexes of physical activity (minute ventilation and motion). HR changes were assumed to be strongly related to within-individual variations of vagal tone. RSA adjusted for respiratory parameters and unadjusted RSA were compared for strength of prediction of other measures. Unadjusted RSA was related to respiratory parameters (R = 0.80) and moderately predicted minute-to-minute HR and activity variances (means = 56%, HR; 48%, minute ventilation; and 37%, motion). Adjusted RSA predicted significantly more HR and activity variance (means = 75%, 76%, and 57%, respectively) with narrower confidence intervals. We conclude that ambulatory RSA magnitude is associated with respiratory variations and physical activity. Adjustment for respiratory parameters substantially improves relations between RSA and significantly vagally mediated HR and physical activity. Concurrent monitoring of respiration and physical activity may enhance HR variability accuracy to predict autonomic control.