Short- and long-term reproducibility of autonomic measures in supine and standing positions
Short- and long-term reproducibility of autonomic measures in supine and standing positions
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DOI：
10.1042/cs20030119
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发表时间：
2004-01-01
期刊：
影响因子：
6
通讯作者：
Urban, M
中科院分区：
文献类型：
--
作者：
Kowalewski, MA;Urban, M
自主神经试验和心率变异性(HRV)已被用来评估心脏自主神经功能和评估长期预后。这项研究的目的是评估HRV参数和自主神经测试根据体位(仰卧或站立)的短期和长期重复性。研究组由26名健康受试者组成。一天中进行两次自主神经测试和心率变异性检查，结果取平均值。然后在每次检查后3天以及6个月和24个月后重复该方案。自主神经测试包括深呼吸、Valsalva动作和等长肌肉练习(握手)，以及对站立做出反应的血压和心率。记录自主呼吸时的心电记录10min，进行心率变异性分析。我们发现，自主神经测试的一些参数的重复性与身体位置[E/I比率(对深呼吸的心率反应)]无关，而其他参数与身体位置(Valsalva动作和持续握手的血压反应)有关。此外，这些参数的日内测量从不可重复性(Valsalva比率、握力和血压对站立的反应)到中等重复性[E/I比率和30/15比率(心率对站立的反应)]。在HRV参数中，我们发现总功率(TP)、低频率(LF)和高频率(HF)不仅在同一天内进行测量，而且在短期和长期观察中都是可重现的，只有低频/高频比取决于体位。我们的结论是，在短期和长期内，只有少数自主神经测试是可重复的。由于在自主呼吸过程中获得的心率变异性参数对于在同一天内以及在短期和长期内进行的测量显示出高度的重复性，当在健康人群中进行长期观察时，应该使用这些参数而不是自主神经测试。
Autonomic nervous tests and heart rate variability (HRV) have been used to assess cardiac autonomic function and to evaluate long-term prognosis. The aim of this study was to evaluate the short- and long-term reproducibility of HRV parameters and autonomic nervous tests according to body position (supine or standing). The study group consisted of 26 healthy subjects. Autonomic nervous tests and HRV were performed twice during the day and the results were averaged. The protocol was then repeated 3 days after each examination and also after 6 and 24 months. Autonomic nervous tests included deep breathing, Valsalva manoeuvre and isometric muscle exercise (handgrip), as well as blood pressure and heart rate in response to standing. ECG recordings were taken for 10 min during spontaneous breathing for HRV analysis. We found that the reproducibility of some parameters of the autonomic nervous test were independent of body position [E/I ratio (heart rate response to deep breathing)], whereas other parameters were dependent on body position (Valsalva manoeuvre and blood pressure response to sustained handgrip). In addition, within-day measurements of those parameters varied from non-reproducible (Valsalva ratio, handgrip and blood pressure response to standing) to moderately reproducible [E/I ratio and 30/15 ratio (heart rate response to standing)]. Among the HRV parameters, we found that total power (TP), low (LF)- and high (HF)- frequency were reproducible not only for measurements made within the same day, but also during short- and long-term observations, and only the LF/HF ratio was dependent on body position. We conclude that only a few autonomic nervous tests are reproducible in the short- and long-term. Because HRV parameters obtained during spontaneous respiration showed high reproducibility for measurements made within the same day as well as in the short- and long-term, they should be used instead of autonomic nervous tests when long-term observations are carried out in a healthy population.