大鼠心率变异性频谱中高频成分的中枢机理分析

本文探讨心率变异性（ＨＲＶ）频谱中高频成分的中枢机理。对正常ＳＤ大量给予不同频率的人工通气并电刺激延髓疑核,观察ＨＲＶ频谱的改变,记录与呼吸节律同步的延髓头端腹外侧区（ｒＶＬＭ）及其周围区神经元细胞外单位放电,对ＨＲＶ和放电变异性进行相干函数分析。结果显示：（１）ＨＲＶ的高频成分的中心频率随着人工通气频率的增加而增加,呈高度线性相关,（ｒ＝０．８３,Ｐ〈０．０００１）;（２）对ｒＶＬＭ及其周围区与     

Cardiovascular variability after arousal from sleep: time-varying spectral analysis.

We performed time-varying spectral analyses of heart rate variability (HRV) and blood pressure variability (BPV) recorded from 16 normal humans during acoustically induced arousals from sleep. Time-varying autoregressive modeling was employed to estimate the time courses of high-frequency HRV power, low-frequency HRV power, the ratio between low-frequency and high-frequency HRV power, and low-frequency power of systolic BPV. To delineate the influence of respiration on HRV, we also computed respiratory airflow high-frequency power, the modified ratio of low-frequency to high-frequency HRV power, and the average transfer gain between respiration and heart rate. During cortical arousal, muscle sympathetic nerve activity and heart rate increased and returned rapidly to baseline, but systolic blood pressure, the ratio between low-frequency and high-frequency HRV power, low-frequency HRV power, the modified ratio of low-frequency to high-frequency HRV power, and low-frequency power of systolic BPV displayed increases that remained above baseline up to 40 s after arousal. High-frequency HRV power and airflow high-frequency power showed concommitant decreases to levels below baseline, whereas the average transfer gain between respiration and heart rate remained unchanged. These findings suggest that 1) arousal-induced changes in parasympathetic activity are strongly coupled to respiratory pattern and 2) the sympathoexcitatory cardiovascular effects of arousal are relatively long lasting and may accumulate if repetitive arousals occur in close succession.     

Comparison of two systems for long-term heart rate variability monitoring in free-living conditions - a pilot study

Objective  

A number of small portable systems that can measure HRV are available to address questions related to autonomic regulation in free-living subjects. However, ambulatory HRV measurements obtained through use of these systems have not previously been validated against standard clinical measurements such as Holter recordings. The objective of this study was to validate HRV obtained using a commonly used system, Actiheart, during occupational and leisure-time activities.     

Automatic filtering of outliers in RR intervals before analysis of heart rate variability in Holter recordings: a comparison with carefully edited data

Background  

Undetected arrhythmic beats seriously affect the power spectrum of the heart rate variability (HRV). Therefore, the series of RR intervals are normally carefully edited before HRV is analysed, but this is a time consuming procedure when 24-hours recordings are analysed. Alternatively, different methods can be used for automatic removal of arrhythmic beats and artefacts. This study compared common frequency domain indices of HRV when determined from manually edited and automatically filtered RR intervals.     

A modified Zeeman model for producing HRV signals and its application to ECG signal generation

Developing a mathematical model for the artificial generation of electrocardiogram (ECG) signals is a subject that has been widely investigated. One of the challenges is to generate ECG signals with a wide range of waveforms, power spectra and variations in heart rate variability (HRV)--all of which are important indexes of human heart functions. In this paper we present a comprehensive model for generating such artificial ECG signals. We incorporate into our model the effects of respiratory sinus arrhythmia, Mayer waves and the important very low-frequency component in the power spectrum of HRV. We use a new modified Zeeman model for generating the time series for HRV, and a single cycle of ECG is produced by using a simple neural network. The importance of the work is the model's ability to produce artificial ECG signals that resemble experimental recordings under various physiological conditions. As such the model provides a useful tool to simulate and analyse the main characteristics of ECG, such as its power spectrum and HRV under different conditions. Potential applications of this model include using the generated ECG as a flexible signal source to assess the effectiveness of a diagnostic ECG signal-processing device.     

Low to high frequency ratio of heart rate variability spectra fails to describe sympatho-vagal balance in cardiac patients

Heart rate variability (HRV) reflects an influence of autonomic nervous system on heart work. In healthy subjects, ratio between low and high frequency components (LF/HF ratio) of HRV spectra represents a measure of sympatho-vagal balance. The ratio was defined by the authorities as an useful clinical tool, but it seems that it fails to summarise sympatho-vagal balance in a clinical setting. Value of the method was re-evaluated in several categories of cardiac patients. HRV was analysed from 24-hour Holter ECGs in 132 healthy subjects, and 2159 cardiac patients dichotomised by gender, median of age, diagnosis of myocardial infarction or coronary artery surgery, left ventricular systolic function and divided by overall HRV into several categories. In healthy subjects, LF/HF ratio correlated with overall HRV negatively, as expected. The paradoxical finding was obtained in cardiac patients; the lower the overall HRV and the time-domain indices of vagal modulation activity were the lower the LF/HF ratio was. If used as a measure of sympatho-vagal balance, long-term recordings of LF/HF ratio contradict to clinical finding and time-domain HRV indices in cardiac patients. The ratio cannot therefore be used as a reliable marker of autonomic activity in a clinical setting.     

A prospective study of the psychobehavioral factors responsible for a change from non-patient irritable bowel syndrome to IBS patient status

Background

The literature measuring effects of antidepressant and electroconvulsive therapy (ECT) for major depression on heart rate variability (HRV) in medically well individuals was reviewed.

Methods

Fourteen studies evaluating HRV were included. Twenty three pre-post or within group comparisons were available. Treatment impact on measures of HRV was pooled over studies. We examined different classes of antidepressants, and for short and long electrocardiogram (ECG) recordings separately.

Results

Tricyclic antidepressants (TCAs) were associated with declines in most measures of HRV and significant increase in heart rate (HR) in studies with short recording intervals. No significant changes were found for longer recording times. Treatment effects with selective serotonin reuptake inhibitors (SSRIs) were more variable. Short-recording studies revealed a significant decrease in HR and an increase in one HRV measure. In two 24-hour recording studies no significant changes were observed. No relationship between ECT and HRV has been established in the literature. The effects of other drugs are reported.

Limitations

Few studies measure the effects of treatment of depression on HRV. Existing studies have generally used very small samples, employing a variety of measurements and methodologies.

Conclusion

We confirm that TCAs are associated with a large decrease in HRV and increase HR. However, data for SSRIs is not clear. Although the effect of SSRIs on HRV is weaker than for TCAs, evidence shows that SSRIs are associated with a small decrease in HR, and an increase in one measure of HRV. The use of TCAs in depression leads to changes in HRV that are associated with increased risk of mortality.     

Heart rate variability signal processing: A quantitative approach as an aid to diagnosis in cardiovascular pathologies

The heart rate variability (HRV) signal carries important information about the systems controlling heat rate and blood pressure, mainly elicited by autonomic nervous system (sympathetic and parasympathetic) controls. The present paper illustrates methods of HRV signal processing by using autoregressive (AR) modeling and power spectral density estimate. The information enhanced in this way seems to be particularly sensitive in discriminating various cardiovascular pathologies (hypertension, myocardial infarction, diabetic neuropathy, etc.). This method provides a simple non-invasive analysis, based on the processing of spontaneous oscillations in heart rate. Particular emphasis is directed to the algorithms used and to their direct application by using proper computerized techniques: only a few paradigmatical examples will be illustrated as preliminary results.     

Time domain analysis of diaphragmatic electromyogram during fatigue in men

Diaphragmatic fatigue has been correlated with a change in the electromyogram recorded from the diaphragm (EMGdi), which suggests that the electromyogram is a potential clinical tool to detect respiratory muscle fatigue. Changes in the EMGdi have previously been quantified by using the power spectral parameters high-low ratio or mean frequency. In this study, we developed an autoregressive model of the EMG in an attempt to improve the analysis of the EMGdi. This model was tested on recordings of the EMGdi that were obtained from an esophageal electrode in five normal subjects breathing to fatigue through an inspiratory resistor. The data obtained from the autoregressive model were directly compared with data from the high-low ratio and mean frequency techniques. The autoregressive model showed an excellent correlation with mean frequency. Both techniques were superior to the high-low ratio measurement. Because the autoregressive model requires much less computation than mean frequency and can be easily implemented in real time on a minicomputer, we propose this as a preferable approach.     

Warm-up phenomenon and cardiac autonomic control in patients with coronary artery disease

Decreased heart rate variability (HRV) and heart rate turbulence (HRT) are independent predictors of mortality after acute myocardial infarction (AMI). There are no previous studies on the relationship between warm-up phenomenon and cardiac autonomic control in stable coronary artery disease (CAD). We investigated the responses in HRV to repeated exercise induced ischemia and differences in global HRV and HRT in patients with and without adaptation to ischemia (warm-up phenomenon). Fifty male patients with CAD underwent two successive exercise tests with ambulatory electrocardiogram (ECG) recordings. HRV was evaluated using time and frequency domain measures and HRT was determined among patients with ventricular premature complexes (VPCs). The patients were divided in two groups on the basis of either positive (warm-up+) or negative (warm-up-) ischemia adaptation. Total power, ULF and VLF power and pNN50 calculated from the entire ECG recording were higher in the group demonstrating warm-up phenomenon (P<0.05 for all). In the assessment of the four short-term stationary phases (pre-and post-test 1 and 2) total power, VLF power and pNN50 were significantly higher in the warm-up positive group already at the baseline (P<0.05 for all). Furthermore, in the entire recordings total power, ULF and VLF power and SDNN correlated positively with the decrease in ischemic burden in the recovery phase (P相似文献   

A Measurement of Electrocardiography and Photoplethesmography in Obese Children

The purpose of this study was to establish heart rate variability normative data on obese children and to comparing the accuracy of two medical technologies photoplethesmography (PPG) with electrocardiography (ECG) while measuring heart rate variability (HRV). PPG is a relatively new technique that holds promise for health care practitioners as an evaluative tool and biofeedback instrument due to its cost and easy administration. This study involved ten children who were recruited for an after-school program designed to reduce obesity. Three-five-minute recordings of HRV were collected while the children were lying in the supine position on a therapy bed. PPG was measured from a thumb sensor and ECG from sensors placed under wristbands on both wrists. The results indicate that PPG is as effective as ECG in measuring the eleven parameters of heart rate variability.     

Heart rate recovery and heart rate complexity following resistance exercise training and detraining in young men

The purpose of this study was to examine heart rate recovery (HRR) and linear/nonlinear heart rate variability (HRV) before and after resistance training. Fourteen young men (25.0 +/- 1.1 yr of age) completed a crossover design consisting of a 4-wk time-control period, 6 wk of resistance training (3 days/wk), and 4 wk of detraining. Linear HRV was spectrally decomposed using an autoregressive approach. Nonlinear dynamics of heart rate complexity included sample entropy (SampEn) and Lempel-Ziv entropy (LZEn). HRR was calculated from a graded maximal exercise test as maximal heart rate attained during the test minus heart rate at 1 min after exercise (HRR). There was no change in SampEn, LZEn, or HRR after the time-control portion of the study (P > 0.05). SampEn (P < 0.05), LZEn (P < 0.05), and HRR (P < 0.05) increased after resistance training and returned to pretraining values after detraining. There was no change in spectral measures of HRV at any time point (P > 0.05). These findings suggest that resistance exercise training increases heart rate complexity and HRR after exercise but has no effect on spectral measures of HRV in young healthy men. These autonomic changes regress shortly after cessation of training.     

Short-term secondhand smoke exposure decreases heart rate variability and increases arrhythmia susceptibility in mice

Exposure to secondhand smoke (SHS), a major indoor air pollutant, is linked to increased cardiovascular morbidity and mortality, including cardiac arrhythmias. However, the mechanisms underlying the epidemiological findings are not well understood. Impaired cardiac autonomic function, indexed by reduced heart rate variability (HRV), may represent an underlying cause. The present study takes advantage of well-defined short-term SHS exposure (3 days, 6 h/day) on HRV and the susceptibility to arrhythmia in mice. With the use of electrocardiograph telemetry recordings in conscious mice, HRV parameters in the time domain were measured during the night after each day of exposure and 24 h after 3 days of exposure to either SHS or filtered air. The susceptibility to arrhythmia was determined after 3 days of exposure. Exposure to a low concentration of SHS [total suspended particle (TSP), 2.4 +/- 3.2; and nicotine, 0.3 +/- 0.1 mg/m(3)] had no significant effect on HRV parameters. In contrast, the exposure to a higher but still environmentally relevant concentration of SHS (TSP, 30 +/- 1; and nicotine, 5 +/- 1 mg/m(3)) significantly reduced HRV starting after the first day of exposure and continuing 24 h after the last day of exposure. Moreover, the exposed mice showed a significant increase in ventricular arrhythmia susceptibility and atrioventricular block. The data suggest that SHS exposure decreased HRV beyond the exposure period and was associated with an increase in arrhythmia susceptibility. The data provide insights into possible mechanisms underlying documented increases in cardiovascular morbidity and mortality in humans exposed to SHS.     

Fractal dimension in health and heart failure.

BACKGROUND: Non-linear analysis of heart rate variability (HRV) can give additional information about autonomic control of the heart rate. This study applied the fractal dimension (FD) in a congestive heart failure (CHF) population. METHODS: FD and HRV were evaluated in a healthy population (n=21) and an end-stage heart failure population (n=21) using 1-h segments during the day and night from Holter recordings. RESULTS: CHF patients presented a loss of circadian variation in both FD and conventional time- and frequency-domain HRV indices. FD was higher in the CHF population both during the day and night. In the CHF population the correlation between FD and high-frequency power of HRV was lost. CONCLUSION: Day-night variations of heart rate fluctuations are lost in heart failure. Changes in FD reflecting physiological and pathophysiological changes were observed.     

Validity of (Ultra-)Short Recordings for Heart Rate Variability Measurements

Objectives

In order to investigate the applicability of routine 10s electrocardiogram (ECG) recordings for time-domain heart rate variability (HRV) calculation we explored to what extent these (ultra-)short recordings capture the “actual” HRV.

Methods

The standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were measured in 3,387 adults. SDNN and RMSSD were assessed from (ultra)short recordings of 10s(3x), 30s, and 120s and compared to 240s–300s (gold standard) measurements. Pearson’s correlation coefficients (r), Bland-Altman 95% limits of agreement and Cohen’s d statistics were used as agreement analysis techniques.

Results

Agreement between the separate 10s recordings and the 240s-300s recording was already substantial (r = 0.758–0.764/Bias = 0.398–0.416/d = 0.855–0.894 for SDNN; r = 0.853–0.862/Bias = 0.079–0.096/d = 0.150–0.171 for RMSSD), and improved further when three 10s periods were averaged (r = 0.863/Bias = 0.406/d = 0.874 for SDNN; r = 0.941/Bias = 0.088/d = 0.167 for RMSSD). Agreement increased with recording length and reached near perfect agreement at 120s (r = 0.956/Bias = 0.064/d = 0.137 for SDNN; r = 0.986/Bias = 0.014/d = 0.027 for RMSSD). For all recording lengths and agreement measures, RMSSD outperformed SDNN.

Conclusions

Our results confirm that it is unnecessary to use recordings longer than 120s to obtain accurate measures of RMSSD and SDNN in the time domain. Even a single 10s (standard ECG) recording yields a valid RMSSD measurement, although an average over multiple 10s ECGs is preferable. For SDNN we would recommend either 30s or multiple 10s ECGs. Future research projects using time-domain HRV parameters, e.g. genetic epidemiological studies, could calculate HRV from (ultra-)short ECGs enabling such projects to be performed at a large scale.     

Inheritance of heart rate variability: the kibbutzim family study

Heart rate variability (HRV) measures are associated with coronary heart disease incidence and mortality. Therefore insight into the genetic and environmental determinants of these measures may have clinical relevance. We assessed the role of genetic and environmental factors of time domain and frequency domain HRV indices. Participants were 451 kibbutz members, aged 15 and up, belonging to 80 families. HRV indices were calculated from Holter recordings measured over 5 min. Our data indicate that for the two time- and four frequency domain indices, a mixture of two normal distributions fit the data significantly better than a single normal distribution (P<0.05). We used complex segregation analysis to infer the modes of inheritance of these HRV measures. We found evidence for possible involvement of a recessive major gene in the inheritance of the root mean square of successive differences in RR intervals (RMSSD), which is predominantly vagally mediated. A putative major gene explains 28%-34% of the adjusted inter-individual variability. The SD, determined by a mixture of mechanisms, is influenced by environmental and polygenic effects, but not by a major gene. The findings regarding the heritability of the frequency domain indices were not conclusive. However, the involvement of genetic factors was not rejected. Additional studies in extended families are needed to confirm the involvement of major genes in the determination of the autonomic activity.     

Blood pressure and heart rate variability response to noninvasive ventilation in patients with exacerbations of chronic obstructive pulmonary disease

Sympathetic activation and parasympathetic withdrawal are commonly observed during acute exacerbations of chronic obstructive pulmonary disease (COPD). We have demonstrated previously that noninvasive positive-pressure ventilation (NPPV) improves parasympathetic neural control of heart rate in patients with obstructive sleep apnea. We hypothesized that NPPV may exert such beneficial effects in COPD as well. Therefore, we assessed the acute effects of NPPV on systemic blood pressure and indexes of heart rate variability (HRV) in 23 patients with acute exacerbations of COPD. The measurements of HRV in the frequency domain were computed by an autoregressive spectral technique. The use of NPPV resulted in significant increases of oxygen saturation (from 89.2+/-1.0 to 92.4+/-0.9 %, p<0.001) in association with reductions in systolic and diastolic blood pressures and heart rate (from 147+/-3 to 138+/-3 mm Hg, from 86+/-2 to 81+/-2 mm Hg, from 85+/-3 to 75+/-2 bpm, p<0.001 for all variables), and increases in ln-transformed high frequency band of HRV (from 6.4+/-0.5 to 7.4+/-0.6 ms(2)/Hz, p<0.01). Reductions in heart rate and increases in ln-transformed HF band persisted after NPPV withdrawal. In conclusion, these findings suggest that NPPV may cause improvements in the neural control of heart rate in patients with acute exacerbations of COPD.     

Operation Everest II: An indication of deterministic chaos in human heart rate variability at simulated extreme altitude

It has been shown that fluctuation of human heartbeat intervals (heart rate variability, HRV) reflects variations in autonomic nervous system activity. We studied HRV at simulated altitudes of over 6000 m from Holter electrocardiograms recorded during the Operation Everest II study (Houston et al. 1987). Stationary, 30-min segments of HRV data from six subjects at sea level and over 6000m were supplied to (1) spectral analysis to evaluate sympathetic and parasympathetic nervous system (SNS, PNS) activity, (2) the analysis of Poincaré section of the phase space trajectory reconstructed on a delayed coordinate system to evaluate whether there was fluctuation with deterministic dynamics, (3) the estimation of the correlation dimension to evaluate a static property of putative attractors, and (4) the analysis of nonlinear predictability of HRV time series which could reflect a dynamic property of the attractor. Unlike HRV at sea level, the recordings at over 6000 m showed a strong periodicity (period of about 20 s) with small cycle-to-cycle perturbation. When this perturbation was expressed on a Poincaré section, it seemed to be likely that the perturbation itself obeyed a deterministic law. The correlation dimensions of these recordings showed low dimensional values (3.5 ± 0.4, mean±SD), whereas those of the isospectral surrogates showed significantly (P < 0.05) higher values (5.3 ±0.5) with embedding dimensions of 5.6 ± 0.9. At over 6000 m, the correlation coefficients between the observed and the predicted time series with the prediction time of < 4 beats were significantly (P < 0.01) higher than those for the surrogate data, whereas there was no significant difference in the nonlinear predictability between the observed and the surrogate data at sea level. The results of the spectral analyses showed that, at over 6000 m, there was hardly any power > 0.15 Hz in the HRV spectra possibly due to PNS withdrawal. Hence, these deterministic and/or chaotic dynamics might be mediated by variations in SNS activity at over 6000 m. Present address and address for correspondence: Laboratory for Exercise Physiology and Biomechanics, Faculty of Education, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan     

Abnormal heart rate regulation in murine hearts with familial hypertrophic cardiomyopathy-related cardiac troponin T mutations

Mutations in cardiac troponin T (cTnT), Δ160E and R92Q, have been linked to familial hypertrophic cardiomyopathy (FHC), and some studies have indicated that these mutations can lead to a high incidence of sudden cardiac death in the relative absence of significant ventricular hypertrophy. Alterations in autonomic function have been documented in patients with hypertrophic cardiomyopathy. We hypothesize that alterations in autonomic function may contribute to mutation-specific clinical phenotypes in cTnT-related FHC. Heart rate (HR) variability (HRV) has been used to assess autonomic function from an electrocardiograph. Nontransgenic, Δ160E, or R92Q mice were implanted with radiofrequency transmitters to obtain continuous electrocardiograph recordings during 24-h baseline and 30-min recordings after β-adrenergic receptor drug injections. Although Δ160E mice did not differ from nontransgenic mice for any 24-h HRV measurements, R92Q mice had impaired HR regulation, as measured by a decrease in the SD of the R-R interval, a decrease in the low frequency-to-high frequency ratio, a decrease in normalized low frequency, and an increase in normalized high frequency. β-Adrenergic receptor density measurements and HRV analysis after drug injections did not reveal any significant differences for Δ160E or R92Q mice versus nontransgenic mice. Arrhythmia analysis revealed both an increased incidence of heart block in R92Q mice at baseline and frequency of premature ventricular contractions after isoproterenol injections in Δ160E and R92Q mice. In addition, Δ160E and R92Q mice exhibited a prolonged P duration after drug injections. Therefore, between two independent and clinically severe cTnT mutations within the same functional domain, only R92Q mice exhibited altered autonomic function, whereas both mutations demonstrated abnormalities in conduction and ventricular ectopy.     

Reduced Heart Rate Variability and Altered Cardiac Conduction after Pre-Eclampsia

Pre-eclampsia is a hypertensive disorder of pregnancy that is associated with elevated maternal risk for cardiovascular disease. The aims of this study were to determine the effect of normal pregnancy on postpartum parameters of the electrocardiogram, and furthermore to determine how a history of pre-eclampsia may affect these parameters. Ten-minute high-resolution (1000 Hz) orthogonal Holter electrocardiogram (ECG) recordings were used to measure heart rate variability (HRV). Signal-averaged P-wave and QRS complex durations were determined. Participants included non-pregnant controls, normotensive parous controls and women with a recent history of PE. While reductions in HRV induced by uncomplicated pregnancy returned to non-pregnant levels by 6–8 months postpartum HRV remained reduced in women with a history of PE compared to control groups. In addition, P-Wave and QRS complex durations were prolonged in PE subjects at 6–8 months postpartum compared to control groups. Only QRS duration was independent of differences in blood pressure. These results suggest increased sympathetic cardiac activity, and delayed myocardial conduction in women after PE; alterations consistent with cardiac remodeling and increased risk for arrhythmia. In examining the association between PE and cardiovascular disease, identification of ECG abnormalities soon after pregnancy in women with a history of PE highlights a unique opportunity for early identification and screening in this population before other risk factors become apparent.