Vesa V Hyrylä, Timo Eronen, Saana Kupari, Mika Venojärvi, Heikki O Tikkanen, Mika P Tarvainen
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引用次数: 0
摘要
心率恢复（HRR）和快速HRR，被认为反映副交感神经再激活，已被认为是全因死亡率的有力预测指标。在这项研究中，我们提出了一个改进的快速HRR参数T30HRR，并调查健康的1型糖尿病（T1D）患者是否有降低的HRR。18例T1D患者（T1D = 15±7岁，HbA1c = 58±0.8 mmol/mol）和35例健康对照者进行最大心肺运动试验。停止运动后，评估T30、T30HRR和单指数衰减以及10、20、30、60、120和300 s时的HRR。与对照组相比，T1D患者的HRR分别为T30HRR（12.6±3.9 bpm vs. 16.4±4.3 bpm, p = 0.013）、T30（520±263 s vs. 361±133 s, p = 0.022）、HRR20（9.2±3.5 vs. 11.6±3.1 bpm, p = 0.046）、HRR30（13.0±4.5 bpm vs. 16.3±4.2 bpm, p = 0.035）和HRR60（23.0±6.8 bpm vs. 28.4±7.1 bpm, p = 0.041）。T1D患者表现出快速HRR减弱，表明迷走神经再激活可能减弱，运动可能揭示了健康T1D患者的亚临床症状。
Attenuated fast heart rate recovery suggests delayed parasympathetic reactivation after cessation of exercise in uncomplicated type 1 diabetes patients.
Heart rate recovery (HRR) and fast HRR, believed to reflect parasympathetic reactivation, have been recognized as powerful predictors of all-cause mortality. In this study we propose a modified fast HRR parameter T30HRR and investigate if otherwise healthy subjects with type 1 diabetes (T1D) have attenuated HRR. Eighteen T1D subjects (T1D = 15 ± 7 years, HbA1c = 58 ± 0.8 mmol/mol) and thirty-five healthy matched control subjects underwent maximal cardiopulmonary exercise test. After cessation of exercise T30, T30HRR and monoexponential decay as well as HRR at 10, 20, 30, 60, 120 and 300 s were assessed. The T1D subjects had diminished HRR described by T30HRR (12.6 ± 3.9 bpm vs. 16.4 ± 4.3 bpm, p = 0.013), T30 (520 ± 263 s vs. 361 ± 133 s, p = 0.022), HRR20 (9.2 ± 3.5 vs. 11.6 ± 3.1 bpm, p = 0.046), HRR30 (13.0 ± 4.5 bpm vs. 16.3 ± 4.2 bpm, p = 0.035) and HRR60 (23.0 ± 6.8 bpm vs. 28.4 ± 7.1 bpm, p = 0.041) when compared to the control subjects. Subjects with T1D exhibited attenuated fast HRR suggesting that vagal reactivation may be diminished, and exercise may unmask subclinical symptoms in otherwise healthy T1D subjects.
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