MONITORING OF HEART RATE VARIABILITY DURING ALCOHOL WITHDRAWAL SYNDROME

该项目的目的是检查心率变异性（HRV）的测量，连续和无创，在男性和女性酗酒者入院戒酒。酒精戒断综合征（AWS）的外周表现以快速变化的自主神经影响为特征。根据AWS的严重程度和阶段，这些可能每分钟、每小时都有所不同。我们开发了对信号非平稳性相对不敏感的HRV测量方法，并在短时间内捕获相关数据。我们现在正在分析接受酒精戒断综合症治疗的人类受试者的数据。已知酗酒者IBI时间序列的复杂性明显低于健康对照者。我们的问题是，4至6周不饮酒是否会导致复杂性测量回归正常基线（如健康对照受试者所定义的），或者信号复杂性降低是否会在4至6周内保持稳定。对这些数据的初步分析表明，心脏信号的复杂性随着最后一次饮酒时间的延长而增加。然而，即使在第4周，该措施也没有回到预期的基线。这表明a)测量恢复到基线所需的时间长度超过4周，b)慢性过量饮酒导致永久性自主神经紊乱，从而改变心脏信号动力学，或c)过量饮酒的受试者在发病前有自主神经功能的改变。与这项工作有关的两份手稿中，一份已出版，一份正在印刷中。另一份手稿正在准备中。在与该项目相关的未来工作中，我们将探讨心脏信号复杂性改变的可能机制。一个需要回答的主要问题是，我们发现的心脏信号动力学的改变是否与心功能的亚临床异常有关。-心脏，戒酒，种族，性别，信号动力学-人类受试者

The purpose of the project was to examine measures of heart rate variability (HRV), continuously and noninvasively, in male and female alcoholics admitted for drinking cessation. The peripheral manifestations of alcohol withdrawal syndrome (AWS) are characterized by rapidly changing autonomic influences. These may vary, minute to minute and hour to hour, depending on the severity and stage of AWS. We developed measures of HRV which are relatively insensitive to non- stationarity of signal and capture relevant data during short periods of measurement. We are now analyzing data from human subjects admitted for treatment of alcohol withdrawal syndrome. Alcoholic subjects are known to have IBI time-series which are significantly less complex than healthy comparison subjects. Our question was whether abstention from alcohol use for a period of 4 to 6 weeks would result in normalization of the complexity measure back to baseline, as defined by healthy comparison subjects or if the decreased signal complexity remains stable for a period of 4 to 6 weeks. Preliminary analysis of this data shows that cardiac signal complexity increases with the length of time since the last intake of alcohol. However, even at 4 weeks, the measure does not return to the expected baseline. This suggests that either a) the length of time required for the measure to return to baseline is longer than 4 weeks, b) chronic excessive alcohol intake results in permanent autonomic disruption resulting in altered cardiac signal dynamics or c) subjects who consume excessive amounts of alcohol have a premorbid alteration in autonomic function. Of two manuscripts related to this work, one has been published and one is in press. One other manuscript is being prepared. In future work related to this project, we will address possible mechanisms of alterations in cardiac signal complexity. One major question to be answered is whether the alterations in cardiac signal dynamics we have found are associated with sub-clinical abnormalities of cardiac function. - heart, alcohol withdrawal, ethnicity, gender, signal dynamics - Human Subjects