Time and frequency domain analyses of heart rate variability in patients with epilepsy
Time and frequency domain analyses of heart rate variability in patients with epilepsy
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DOI：
10.1016/j.eplepsyres.2005.02.001
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发表时间：
2005-02-01
影响因子：
2.2
通讯作者：
Kilic, M
中科院分区：
文献类型：
--
作者：
Evrengül, H;Tanriverdi, H;Kilic, M
心率变异性（HRV）是检测猝死（SD）患者自主神经系统交感-副交感神经平衡的有用工具。SD在癫痫患者中更常见，其确切机制尚不清楚。癫痫患者的自主神经系统受累很少被研究，并显示出相互矛盾的结果。我们的目的是确定癫痫患者与正常人群相比HRV是否有任何变化。对43例癫痫患者进行了短期HRV频域和时域分析，这些癫痫患者有全身强直阵挛发作（GTCS），并且没有服用任何药物，还在43名年龄和性别匹配的对照组中进行了分析。在时域分析中，患者显示出比健康受试者更高的SDNN（所有R-R间期的标准差）、SDANN（5分钟记录中平均NN间期的标准差）和HRV三角指数（p < 0.0001）。与健康受试者相比，患者倾向于显示更高的pNN 50（与相邻间期相差> 50 ms的R-R间期数除以所有R-R间期总数）和RMSSD（连续差异的均方根）值，但差异无统计学意义（p > 0.05）。在频域分析中，HRV的频谱测量显示高频（HF）值减少（是副交感神经活动的标志）和低频（LF）值的增加（是交感神经活动的量度）;结果，低频和高频之间的比率（LF/HF）显著增加（分别为p < 0.0001、p < 0.0001和p < 0.001）。我们的数据表明，增加交感神经控制的心率癫痫患者谁有GTCS。这种交感神经活动的增加可能在癫痫患者室性快速性心律失常的发生中起关键作用，并可能与癫痫患者猝死的发生率高于对照组有关。(c)2005 Elsevier B. V.保留所有权利。
Heart rate variability (HRV) is a useful tool for the detection of sympathetic-parasympathetic balance of autonomic nervous system in patients at risk of sudden death (SD). SD is more common in patients with epilepsy and the exact mechanisms of SD are unknown. Autonomic nervous system involvement in patients with epilepsy has rarely been studied and has shown conflicting results. Our purpose was to determine if HRV showed any changes in patients with epilepsy in comparison with normal population. A short period analysis of HRV was performed for both the frequency and time domain in 43 epilepsy patients who had generalized tonic-clonic seizures (GTCS) and who were not taking any medications and also in 43 age and sex matched controls. In the time domain analysis, patients displayed higher SDNN (standard deviation of all R-R intervals), SDANN (standard deviation of mean NN intervals in 5 min recordings) and HRV triangular index than did healthy subjects (p < 0.0001). Patients tended to display higher pNN50 (number of R-R intervals differed by > 50ms from adjacent interval divided by the total number of all R-R intervals) and RMSSD (root-mean-square of successive differences) values than did healthy subjects, but the differences were not statistically significant (p > 0.05). In the frequency domain analysis, the spectral measures of HRV showed a reduction of high frequency (HF) values (is a marker of parasympathetic activity) and an increase of low frequency (LF) values (is a measure of sympathetic activity); as a result, the ratio between low and high frequencies (LF/HF) was significantly increased (p < 0.0001, p < 0.0001 and p < 0.001, respectively). Our data suggests an increase in the sympathetic control of the heart rate in epilepsy patients who have GTCS. This increased sympathetic activity could play a key role in the development of ventricular tachyarrhythmias in patients with epilepsy and may be related to the higher incidence of sudden death in this disorder as compared to controls. (c) 2005 Elsevier B.V. All rights reserved.