SUDEP and heart rate variability.
SUDEP and heart rate variability.
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SUDEP 和心率变异性。
DOI：
10.1016/j.eplepsyres.2010.03.013
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发表时间：
2010
影响因子：
2.2
通讯作者：
DeGiorgio,AndrewC
中科院分区：
文献类型：
--
作者：
DeGiorgio,ChristopherM;DeGiorgio,AndrewC
我们饶有兴趣地阅读了Surges等人关于心率变异性（HRV）和癫痫不明原因猝死（SUDEP）的病例对照研究的重要文章（Surges等人，2009）。Surges回顾性地检查了一组7名SUDEP受害者和7名年龄匹配的对照者的HRV的多项指标。令作者惊讶的是，HRV指标的差异并不显著。然而，当人们仔细回顾HRV数据，特别是高频HRV指标（RMSSD和高频谱功率）时，很明显，两组之间存在实质性的数值差异（Surges et al 2009）。考虑高频HRV很重要，因为它与心脏的迷走神经/副交感神经控制相关，低值表明心脏节律的中枢神经系统控制功能障碍（Stein et al 1993; Kleiger et al 1987）。在从4收集的数据中：00 - 5：00 pm时，SUDEP组的RMSSD和高频谱功率的平均值明显低于对照组（Surges等人，2009）。例如，SUDEP组的平均RMSSD为38 msec（SD 12 msec），而对照组的平均RMSSD为46 msec（SD 23 msec）。对于高频光谱功率，差异和标准差的幅度甚至更高。SUDEP组的平均值为297 msec2（SD 178 msec2），而对照组的平均HFSP为500 msec2（SD 449 msec2）。这表明两组之间存在40%的差异。由于样本量较小，两种测量的标准差较大，因此无法检测到显著差异并不奇怪。Surges et al.承认，"HRV参数的个体间变异性相对较大.
We read with interest the important article by Surges et al. regarding their case-controlled study of heart rate variability (HRV) and sudden unexplained death in epilepsy (SUDEP)(Surges et al 2009). Surges retrospectively examined multiple measures of HRV in a group of seven SUDEP victims and seven age-matched controls. To the authors' surprise, differences in HRV measures were not significant.However, when one carefully reviews the HRV data, specifically measures of high-frequency HRV (RMSSD and High Frequency Spectral Power), it is clear that there are substantial numerical differences between the two groups (Surges et al 2009). High-frequency HRV is important to consider because it is associated with vagus nerve/parasympathetic control of the heart, and low values indicate dysfunctional central nervous system control of the cardiac rhythm (Stein et al 1993; Kleiger et al 1987). In data gathered from 4: 00–5: 00 pm, mean values of both RMSSD and High Frequency Spectral Power were noticeably lower in the SUDEP group than in the control group (Surges et al 2009). For example, the SUDEP group showed a mean RMSSD of 38 msec (SD 12 msec), while the control group had a mean of 46 msec (SD 23 msec). For High Frequency Spectral Power the magnitude of the difference and standard deviation were even higher. The SUDEP group had a mean of 297 msec2 (SD 178 msec2) versus a mean HFSP of 500 msec2 (SD 449 msec2) for the control group. This represents a 40% difference between the groups. With the small sample size and the large standard deviations in both measures, it is not surprising that a significant difference could not be detected. Surges et al. admit,“The inter-individual variability of HRV parameters is relatively large…” and “… Our failure to detect any difference in inter-ictal HRV in SUDEP and control patients could therefore be due to small sample size”(Surges et al 2009).