Hyperthyroidism is characterized by both increased sympathetic and decreased vagal modulation of heart rate: evidence from spectral analysis of heart rate variability
Hyperthyroidism is characterized by both increased sympathetic and decreased vagal modulation of heart rate: evidence from spectral analysis of heart rate variability
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DOI：
10.1111/j.1365-2265.2006.02514.x
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发表时间：
2006-06-01
影响因子：
3.2
通讯作者：
Chu, Woei-Chyn
中科院分区：
文献类型：
--
作者：
Chen, Jin-Long;Chiu, Hung-Wen;Chu, Woei-Chyn
目的甲状腺功能亢进症的临床表现与肾上腺素能亢进症相似。本研究旨在评价甲亢对自主神经系统（ANS）的影响，并探讨甲亢患者血清甲状腺激素浓度与心率频谱变异性（HRV）分析参数之间的关系。（平均年龄31岁）和32名性别、年龄和体重指数（BMI）匹配的正常对照者被招募来接受单通道心电图（ECG）记录。这表明窦房结的自主调节。结果甲亢患者血清甲状腺激素水平与心率变异性（HRV）频谱参数之间存在显著性差异与对照组比较，下列心率变异性参数有显著性差异（P < 0.001）：总功率（TP）、甚低频功率（VLF）、低频功率（LF）、高频功率（HF）和以归一化单位表示的HF（HF%）的降低; LF的归一化单位（LF%）和LF与HF的比率（LF/HF）增加。甲状腺功能亢进症矫正后。在28名患者中，所有上述参数均恢复到与对照组相当的水平。此外，血清甲状腺激素浓度与HRV频谱参数呈显著相关。结论甲亢患者处于交感-迷走神经失衡状态，交感神经对心率的调节作用增强，迷走神经对心率的调节作用减弱。HRV频谱分析可同时检测甲亢患者的自主神经功能障碍，其频谱参数可反映甲亢患者的病情严重程度。
Objective The clinical manifestations of hyperthyroidism resemble those of the hyperadrenergic state. This study was designed to evaluate the impact of hyperthyroidism on the autonomic nervous system (ANS) and to investigate the relationship between serum thyroid hormone concentrations and parameters of spectral heart rate variability (HRV) analysis in hyperthyroidism.Design and patients Thirty-two hyperthyroid Graves' disease patients (mean age 31 years) and 32 sex-, age-, and body mass index (BMI)-matched normal control subjects were recruited to receive one-channel electrocardiogram (ECG) recording.Measurements The cardiac autonomic nervous function was evaluated by the spectral analysis of HRV, which indicates the autonomic modulation of the sinus node. The correlation coefficients between serum thyroid hormone concentrations and parameters of the spectral HRV analysis were also computed.Results The hyperthyroid patients revealed significant differences (P < 0.001) compared with the controls in the following HRV parameters: a decrease in total power (TP), very low frequency power (VLF), low frequency power (LF), high frequency power (HF), and HF in normalized units (HF%); and an increase in LF in normalized units (LF%) and in the ratio of LF to HF (LF/HF). After correction of hyperthyroidism. in 28 patients, all of the above parameters were restored to levels comparable to those of the controls. In addition, serum thyroid hormone concentrations showed significant correlations with spectral HRV parameters.Conclusions Hyperthyroidism is in a sympathovagal imbalanced state, characterized by both increased sympathetic and decreased vagal modulation of the heart rate. These autonomic dysfunctions can be detected simultaneously by spectral analysis of HRV, and the spectral HRV parameters could reflect the disease severity in hyperthyroid patients.