Heart rate acceleration and deceleration capacities associated with circadian blood pressure variation
Heart rate acceleration and deceleration capacities associated with circadian blood pressure variation
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心率加速和减速能力与昼夜血压变化相关
DOI：
10.1111/anec.12748
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发表时间：
2020-02-27
影响因子：
1.9
通讯作者：
Yuan, Jiamin
中科院分区：
文献类型：
--
作者：
Yan, Liyuan;Jin, Jianling;Yuan, Jiamin
背景心率加速和减速能力是可以量化交感神经和迷走神经调制的新参数。然而，如何加速和减速能力与昼夜血压（BP）variation.Methods相关的原发性高血压患者共141例纳入我们的研究。根据夜间收缩压（SBP）下降率将患者分为勺型和非勺型两组。收集基线人口统计学特征、动态血压监测（ABPM）参数、霍尔特记录和超声心动图参数。（-7.75 [-8.45类似于-6.3] ms对-6.6 [-8.25类似于-5.2] ms，p = 0.047）和减速能力（DC）（7.35 [6.1相似于8.1] ms vs. 6.3 [5.1相似于7.6] ms，p = 0.042）在杓型患者中显著高于非杓型患者。通过多变量logistic回归分析，发现左心房直径（LAD）是加速容量模型（优势比1.174，95%置信区间1.019-1.354，p = .027）和减速模型（优势比1.146，95%置信区间1.003-1.309，p = .045）中非勺状态的独立危险因素。睡眠收缩压与加速能力呈正相关（r = 0.256，p = 0.002），与减速能力呈负相关（r =-0.194，p = 0.021）。结论杓型高血压患者的加速能力和减速能力的绝对值高于非杓型高血压患者。然而，加速和减速能力不是血压变钝的独立危险因素。睡眠收缩压与自主神经系统功能损害的相关性较其他ABPM参数更好。
Background Heart rate acceleration and deceleration capacities are novel parameters that can quantify sympathetic and vagal modulation. However, how acceleration and deceleration capacities associated with circadian blood pressure (BP) variation remains unknown.Methods A total of 141 patients with essential hypertension were included in our study. Based on the nocturnal decline rate of systolic BP (SBP), patients were divided into two groups, as dippers and nondippers. Baseline demographic characteristics, ambulatory blood pressure monitoring (ABPM) parameters, Holter recordings, and echocardiographic parameters were collected.Results The absolute values of acceleration capacity (AC) (-7.75 [-8.45 similar to -6.3] ms vs. -6.6 [-8.25 similar to -5.2] ms, p = .047) and deceleration capacity (DC) (7.35 [6.1 similar to 8.1] ms vs. 6.3 [5.1 similar to 7.6] ms, p = .042) were significantly higher in dippers than in nondippers. By multivariate logistic regression analysis, left atrial diameter (LAd) was found to be an independent risk factor for nondipper status in acceleration capacity model (odds ratio 1.174, 95% confidence interval 1.019-1.354, p = .027) and deceleration model (odds ratio 1.146, 95% confidence interval 1.003-1.309, p = .045). Sleep SBP was positively correlated to acceleration capacity (r = .256, p = .002) and negatively correlated to deceleration capacity (r = -.194, p = .021).Conclusions The absolute values of acceleration capacity and deceleration capacity were higher in patients with dipper hypertension than in patients with nondipper hypertension. However, acceleration and deceleration capacities were not independent risk factors for blunted BP variation. Sleep SBP seemed to be better correlated to the impairment of autonomic nervous system (ANS) function than other ABPM parameters.