心率变异性与不稳定的窦性心律相混淆

P. Stein, D. Yanez, P. Domitrovich, J. Gottdiener, P. Chaves, R. Kronmal, P. Rautaharju
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引用次数: 13

摘要

降低心率变异性(HRV)预示不良后果。心率变异可因明显的非呼吸性窦性心律失常(即,p波正常的高度不稳定的窦性心律,ESR)发作而升高。这种升高的HRV可能通过增加高危患者的HRV而混淆风险分层。心率变异是根据心血管健康研究(一项针对老年人的人口研究)中记录的基线磁带确定的。比较ESR+和ESR$受试者24小时时间、频率和非线性域HRV, (CVD+)和(CVD-)心血管疾病。ESR+与时间域和频域HRV升高、短期分形标度指数降低和庞加莱图拟合椭圆的维数比增大有关。(ESR+和CVD+)几乎所有指标的HRV都最高,而(ESR-和CVD+)的HRV最低。由于HRV下降与不良结果相关,ESR可能会削弱HRV的预测能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Heart rate variability is confounded by the presence of erratic sinus rhythm
Decreased heart rate variability (HRV) predicts adverse outcomes. HRV can be elevated by episodes of significant non-respiratory sinus arrhythmia (i.e., a highly erratic sinus rhythm with normal p-waves, ESR). This elevated HRV could confound risk stratification by increasing HRV in high-risk patients. HRV was determined from tapes recorded at baseline in the Cardiovascular Health Study, a population study of older adults. Twenty-four hour time, frequency and non-linear domain HRV was compared between ESR+ and ESR$subjects, with (CVD+) and without (CVD-) cardiovascular disease. ESR+ was associated with higher HRV in the time and frequency domains and with decreased short-term fractal scaling exponent and increased ratios of the dimensions of the Poincare plot fitted ellipse. (ESR+ and CVD+) subjects with had the highest HRV for virtually all indices, while (ESR- and CVD+) had the lowest HRV. Since decreased HRV is associated with adverse outcomes, ESR is likely to dilute the predictive power of HRV.
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