Heart Rate Variability -- Alcohol Withdrawal Syndrome

该项目的目的是检查因戒酒入院的男性和女性酒精患者的心率变异性(HRV)测量。我们的问题是，戒酒4至6周是否会导致心脏信号复杂性恢复到健康对照受试者定义的基线水平，或者降低的信号复杂性是否在4至6周内保持稳定。我们感兴趣的结果变量是从EKG获得的心搏间期时间序列的赫斯特指数，这是HRV的一个很好的衡量标准。赫斯特指数是时间序列自相关性的非线性度量，在我们之前的工作中发现，在没有酒精戒断综合症症状的情况下，在戒酒48小时后，酒精受试者的赫斯特指数增加。我们已经确定，在酗酒的受试者中，信号复杂性的测量在5周结束时不会回到基线，而是达到一条比对照组更高的渐近线。我们还发现，在这一测量中存在性别和年龄差异。我们对这种反应随时间的推移进行了建模，发现它与S型反应结构非常吻合。其他研究人员的工作发现，在酒精受试者中发现自相关性降低的受试者有更大的猝死风险，因此我们假设，正如几项大型流行病学研究所确定的那样，酒精受试者自主心率控制的改变也可能是该人群猝死的风险因素。我们将终止这个项目，因为我们正在转向非人类灵长类动物和啮齿动物模型，以回答由这项工作产生的几个机械问题。与该项目相关的最终结果已经公布。(Karimullah K，George DT，DePetrillo PB.酒精依赖者短期戒酒后心电间期动态变化的时程研究。EUJ Pharmacol。2001年9月21日；427(3)：227-233。)

The purpose of the project was to examine measures of heart rate variability (HRV) in male and female alcoholics admitted for drinking cessation. Our question was whether abstention from alcohol use for a period of 4 to 6 weeks would result in normalization of the cardiac signal complexity measure back to baseline, as defined by healthy comparison subjects or if the decreased signal complexity remained stable for a period of 4 to 6 weeks. Our outcome variable of interest was the Hurst exponent of the interbeat interval time series obtained from the EKG, which is a good measure of HRV. The Hurst exponent is a non-linear measure of the autocorrelation of the time series, and in our previous work was found to be increased in alcoholic subjects when obtained 48 hours after cessation of alcohol use with no symptoms of alcohol withdrawal syndrome present. We have determined that in alcoholic subjects, measures of signal complexity do not return to baseline at the end of 5 weeks, but reach an asymptote which is higher than controls. We also found that there were gender and age differences in this measure. We modeled this response over time and found a good fit to a sigmoid response construct. Work by other investigators has found that subjects with decreased measures of autocorrelation as found in this study in alcoholic subjects have a greater risk of sudden death, therefore we hypothesize that altered autonomic contol of heart rate in alcoholics may also be a risk factor for sudden death in this population, as has been determined from several large epidemiologic studies. We are terminating this project as we are moving to non-human primates and rodent models to answer several mechanistic questions resulting from this work. The final results related to this project have been published. (Karimullah K, George DT, DePetrillo PB. The time-course of electrocardiographic interbeat interval dynamics in alcoholic subjects after short-term abstinence. Eur J Pharmacol. 2001 Sep 21;427(3):227-233.)