Coronary artery disease - Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men
Coronary artery disease - Decreased heart rate variability is associated with higher levels of inflammation in middle-aged men
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DOI：
10.1016/j.ahj.2008.07.009
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发表时间：
2008-10-01
影响因子：
4.8
通讯作者：
Vaccarino, Viola
中科院分区：
文献类型：
--
作者：
Lampert, Rachel;Bremner, J. Douglas;Vaccarino, Viola
背景许多冠状动脉疾病(CAD)的传统危险因素与自主神经功能改变有关。炎症可能在危险因素、自主神经功能障碍和冠心病之间提供联系。我们研究了心率变异性(HRV)和炎症之间的关系，心率变异性(HRV)是衡量自主神经功能的指标，炎症反应是通过C-反应蛋白(CRP)和白介素6(IL-6)来衡量的。所有患者均行动态心电图监测，用功率谱分析方法计算24小时的超低、极低、低、高频功率。结果体力活动、BMI、高密度脂蛋白胆固醇、吸烟、抑郁、高血压和高血压与C反应蛋白、IL-6水平呈正相关，与一个或多个HRV变量呈负相关。HRV各参数(高频除外)与CRP、IL-6呈显著负相关。在调整了年龄、BMI、活动量、高密度脂蛋白、吸烟、高血压、抑郁和糖尿病后，超低频和甚低频仍然是CRP的显著预测因素(P<；0.01)。结论C-反应蛋白与HRV降低有关，即使在控制了传统的CAD危险因素后也是如此。自主神经失调导致炎症可能是传统危险因素促进冠心病发展的一条途径。
Background Many traditional risk factors for coronary artery disease (CAD) are associated with altered autonomic function. Inflammation may provide a link between risk factors, autonomic dysfunction, and CAD. We examined the association between heart rate variability (HRV), a measure of autonomic function, and inflammation, measured by C-reactive protein (CRP) and interleukin-6 (IL-6).Methods We examined 264 middle-aged male twins free of symptomatic CAD. All underwent ambulatory electrocardiogram monitoring and 24-hour ultra low, very low, low, and high-frequency power were calculated using power spectral analysis. C-reactive protein and IL-6 were measured, and risk factors including age, smoking, hypertension, lipids, diabetes, body mass index (BMI), depression, and physical activity were assessed.Results Physical activity, BMI, high-density lipoprotein cholesterol, smoking, depression, and hypertension were directly associated with CRP and IL-6 and inversely associated with one or more HRV variables. There was a graded inverse relationship between all HRV parameters (except high frequency) and CRP and IL-6. After adjustment for age, BMI, activity, high-density lipoprotein, smoking, hypertension, depression, and diabetes, ultra low frequency and very low frequency remained significant predictors of CRP (P < .01).Conclusions C-reactive protein is associated with decreased HRV, even after controlling for traditional CAD risk factors. Autonomic dysregulation leading to inflammation may represent one pathway through which traditional risk factors promote development of CAD.