Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society
Advances in heart rate variability signal analysis: joint position statement by the e-Cardiology ESC Working Group and the European Heart Rhythm Association co-endorsed by the Asia Pacific Heart Rhythm Society
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DOI：
10.1093/europace/euv015
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发表时间：
2015-09-01
期刊：
影响因子：
6.1
通讯作者：
Yamamoto, Yoshiharu
中科院分区：
文献类型：
--
作者：
Sassi, Roberto;Cerutti, Sergio;Yamamoto, Yoshiharu
在1996年发表了关于心率变异性（HRV）的工作组文件之后，已经发表了许多文章来描述新的HRV方法及其在不同生理和临床研究中的应用。本文件提出了一个新的方法的批判性审查。特别注意1996年标准化文件中没有报告但最近在足够规模的人口中进行了测试的方法。考虑了以下方法：长程相关性和分形分析;短期复杂性;熵和规律性;非线性动力系统和混沌行为。对每种方法的技术方面、临床成果和临床应用建议进行了综述。虽然新方法有助于对HRV信号特征的技术理解，但它们在开发新的临床工具（例如用于识别高风险患者的工具）方面的成功相当有限。然而，专业实验室在选定的患者人群中获得的现有结果是令人感兴趣的，但需要新的前瞻性研究。必须鼓励研究描述心率复杂调节机制的新参数，因为传统方法无法捕获HRV信号中的所有信息。因此，新技术在经过适当的验证后，可以提供额外的生理和临床意义。临床心脏病学和复杂信号处理方法相结合的多学科对话和专业课程似乎保证了心脏振荡研究和理解正常和异常心脏控制过程的进一步进展。
Following the publication of the Task Force document on heart rate variability (HRV) in 1996, a number of articles have been published to describe new HRV methodologies and their application in different physiological and clinical studies. This document presents a critical review of the new methods. A particular attention has been paid to methodologies that have not been reported in the 1996 standardization document but have been more recently tested in sufficiently sized populations. The following methods were considered: Long-range correlation and fractal analysis; Short-term complexity; Entropy and regularity; and Nonlinear dynamical systems and chaotic behaviour. For each of these methods, technical aspects, clinical achievements, and suggestions for clinical application were reviewed. While the novel approaches have contributed in the technical understanding of the signal character of HRV, their success in developing new clinical tools, such as those for the identification of high-risk patients, has been rather limited. Available results obtained in selected populations of patients by specialized laboratories are nevertheless of interest but new prospective studies are needed. The investigation of new parameters, descriptive of the complex regulation mechanisms of heart rate, has to be encouraged because not all information in the HRV signal is captured by traditional methods. The new technologies thus could provide after proper validation, additional physiological, and clinical meaning. Multidisciplinary dialogue and specialized courses in the combination of clinical cardiology and complex signal processing methods seem warranted for further advances in studies of cardiac oscillations and in the understanding normal and abnormal cardiac control processes.