心率變異性研究進展_《華西醫學》

作者：

洪必瑩 , 何森 ,  陳曉平

四川大學華西醫院心內科（成都，610041）;

關鍵詞：

心率變異性心血管疾病自主神經系統

DOI：

10.7507/1002-0179.20130195

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大量流行病學資料顯示，心率變異性的降低在一般人群及心血管疾病人群中都預示著不良預后，包括高血壓、充血性心力衰竭、心肌梗死后致死性心律失常、糖尿病神經癥等，并且低心率變異性已被證實為心律失常事件和心肌梗死后死亡的獨立危險因子。近年來，心率變異性的分析方法不斷改進，并出現一些新的方式，這對于相關疾病預后的評估具有重要意義。

引用本文： 洪必瑩,何森,陳曉平. 心率變異性研究進展. 華西醫學, 2013, 28(4): 614-618. doi: 10.7507/1002-0179.20130195 復制

1.	Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors[J]. Int J Cardiol, 2010, 141(2): 122-131.
2.	Papaioannou VE. Heart rate variability, baroreflex function and heart rate turbulence: possible origin and implications[J]. Hellenic J Cardiol, 2007, 48(5): 278-289.
3.	Kleiger RE, Stein PK, Bigger JT Jr. Heart rate variability: measurement and clinical utility[J]. Ann Noninvasive Electrocardiol, 2005, 10(1): 88-101.
4.	Kleiger RE, Stein PK, Bosner MS, et al. Time domain measurements of heart rate variability[J]. Cardiol Clin, 1992, 10(3): 487-498.
5.	Brown TE, Beightol LA, Koh J, et al. Important influence of respiration on human R-R interval power spectral is largely ignored[J]. Appl Physiol, 1993, 75(5): 2310-2317.
6.	Furlan R, Guzzetti S, Crivellaro W, et al. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects[J]. Circulation, 1990, 81(2): 537-547.
7.	Bigger JT Jr, Fleiss JL, Steinman RC, et al. Frequency domain measures of heart period variability and mortality after myocardial infarction[J]. Circulation, 1992, 85(1): 164-171.
8.	Voss A, Schulz S, Schroeder R, et al. Methods derived from nonlinear dynamics for analysing heart rate variability[J]. Philos Transact A Math Phys Eng Sci, 2009, 367(1887): 277-296.
9.	Huikuri HV, Mäkikallio TH, Peng CK, et al. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction[J]. Circulation, 2000, 101(1): 47-53.
10.	Karmakar CK, Khandoker AH, Voss A, et al. Sensitivity of temporal heart rate variability in poincare plot to changes in parasympathetic nervous system activity[J]. Biomed Eng Online, 2011, 10: 17.
11.	Watanabe MA, Schmidt G. Heart rate turbulence: a 5-year review[J]. Heart Rhythm, 2004, 1(6): 732-738.
12.	Wolff MW, Varigos GA, Hunt D, et al. Sinus arrhythmia in acute myocardial infarction [J]. Med J Aust, 1987, 2(2): 52-53.
13.	La Rovere MT, Pinna GD, Hohnloser SH, et al. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials[J]. Circulation, 2001, 103(16): 2072-2077.
14.	Camm AJ, Pratt CM, Schwartz PJ, et al. Mortality in patients after a recent myocardial infarction: a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification[J]. Circulation, 2004, 109(8): 990-996.
15.	Bouvy ML, Heerdink ER, Leufkens HG, et al. Predicting mortality in patients with heart failure: a pragmatic approach[J]. Heart, 2003, 89(6): 605-609.
16.	Brouwer J, Van Veldhuisen DJ, Manin’t Veld AJ, et al. Circadian pattern of heart rate variability in heart failure is progressively disturbed with increasing neurohormonal activation[J]. J Am Coll Cardiol, 1994, 24(suppl A): 392A.
17.	Tuininga YS, van Veldhuisen DJ, Crijns HJ, et al. Exploratory study of the effects of single doses of isomazole on hemodynamics and heart rate variability parameters in chronic heart failure[J]. J Cardiovasc Pharmacol, 1995, 25(1): 8 1-86.
18.	La Rovere MT, Pinna GD, Maestri R, et al. Short-term heart rate variability Strongly predicts sudden cardiac death in chronic heart failure patients[J]. Circulation, 2003, 107(4): 565-570.
19.	呂聰敏. 原發性高血壓合并ST-T改變者心律失常檢測與心率變異性分析[J]. 中國實用神經疾病雜志, 2009, 12(14): 12-15.
20.	Guzzetti S, Piccaluga E, Casati R, et al. Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability[J]. J Hypertens, 1988, 6(9): 711-717.
21.	隋敏生，王良玉，張鈺. 高血壓病心率變異性與臨床心血管事件發生的關系的研究[J]. 現代預防醫學, 2005, 32(8): 906-907.
22.	Sucharita S, Bantwal G, Idiculla J, et al. Autonomic nervous system function in type 2 diabetes using conventional clinical autonomic tests, heart rate and blood pressure variability measures[J]. Indian J Endocrinol Metab, 2011, 15(3): 198-203.
23.	de Jong MJ, Randall DC. Heart rate variability in the assessment of autonomic function in heart failure[J]. J Cardiovasc Nurs, 2005, 20(3): 186-195.
24.	Ahmad S, Tejuja A, Newman KD, et al. Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection[J]. Crit Care, 2009, 13(6): 232.
25.	Fang SC, Cassidy A, Christiani DC. A systematic review of occupational exposure to particulate matter and cardiovascular disease[J]. Int J Environ Res Public Health, 2010, 7(4): 1773-1806.
26.	Aerts MB, Synhaeve NE, Mirelman A, et al. Is heart rate variability related to gait impairment in patients with Parkinson’s disease? A pilot study[J]. Parkinsonism Relat Disord, 2009, 15(9): 712-715.
27.	Tseng CD, Wang TL, Lin JL, et al. The mechanism of sympathovagal imbalance in patients with myocardial ischemia[J]. Jpn Heart J, 1996, 37(1): 43-58.
28.	Routledge FS, Campbell TS, McFetridge-Durdle JA, et al. Improvement in heart rate variability with exercise therapy[J]. Can J Cardiol, 2010, 26(6): 303-312.

1. 　Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors[J]. Int J Cardiol, 2010, 141(2): 122-131.
2. 　Papaioannou VE. Heart rate variability, baroreflex function and heart rate turbulence: possible origin and implications[J]. Hellenic J Cardiol, 2007, 48(5): 278-289.
3. 　Kleiger RE, Stein PK, Bigger JT Jr. Heart rate variability: measurement and clinical utility[J]. Ann Noninvasive Electrocardiol, 2005, 10(1): 88-101.
4. 　Kleiger RE, Stein PK, Bosner MS, et al. Time domain measurements of heart rate variability[J]. Cardiol Clin, 1992, 10(3): 487-498.
5. 　Brown TE, Beightol LA, Koh J, et al. Important influence of respiration on human R-R interval power spectral is largely ignored[J]. Appl Physiol, 1993, 75(5): 2310-2317.
6. 　Furlan R, Guzzetti S, Crivellaro W, et al. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects[J]. Circulation, 1990, 81(2): 537-547.
7. 　Bigger JT Jr, Fleiss JL, Steinman RC, et al. Frequency domain measures of heart period variability and mortality after myocardial infarction[J]. Circulation, 1992, 85(1): 164-171.
8. 　Voss A, Schulz S, Schroeder R, et al. Methods derived from nonlinear dynamics for analysing heart rate variability[J]. Philos Transact A Math Phys Eng Sci, 2009, 367(1887): 277-296.
9. 　Huikuri HV, Mäkikallio TH, Peng CK, et al. Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction[J]. Circulation, 2000, 101(1): 47-53.
10. 　Karmakar CK, Khandoker AH, Voss A, et al. Sensitivity of temporal heart rate variability in poincare plot to changes in parasympathetic nervous system activity[J]. Biomed Eng Online, 2011, 10: 17.
11. 　Watanabe MA, Schmidt G. Heart rate turbulence: a 5-year review[J]. Heart Rhythm, 2004, 1(6): 732-738.
12. 　Wolff MW, Varigos GA, Hunt D, et al. Sinus arrhythmia in acute myocardial infarction [J]. Med J Aust, 1987, 2(2): 52-53.
13. 　La Rovere MT, Pinna GD, Hohnloser SH, et al. Baroreflex sensitivity and heart rate variability in the identification of patients at risk for life-threatening arrhythmias: implications for clinical trials[J]. Circulation, 2001, 103(16): 2072-2077.
14. 　Camm AJ, Pratt CM, Schwartz PJ, et al. Mortality in patients after a recent myocardial infarction: a randomized, placebo-controlled trial of azimilide using heart rate variability for risk stratification[J]. Circulation, 2004, 109(8): 990-996.
15. 　Bouvy ML, Heerdink ER, Leufkens HG, et al. Predicting mortality in patients with heart failure: a pragmatic approach[J]. Heart, 2003, 89(6): 605-609.
16. 　Brouwer J, Van Veldhuisen DJ, Manin’t Veld AJ, et al. Circadian pattern of heart rate variability in heart failure is progressively disturbed with increasing neurohormonal activation[J]. J Am Coll Cardiol, 1994, 24(suppl A): 392A.
17. 　Tuininga YS, van Veldhuisen DJ, Crijns HJ, et al. Exploratory study of the effects of single doses of isomazole on hemodynamics and heart rate variability parameters in chronic heart failure[J]. J Cardiovasc Pharmacol, 1995, 25(1): 8 1-86.
18. 　La Rovere MT, Pinna GD, Maestri R, et al. Short-term heart rate variability Strongly predicts sudden cardiac death in chronic heart failure patients[J]. Circulation, 2003, 107(4): 565-570.
19. 　呂聰敏. 原發性高血壓合并ST-T改變者心律失常檢測與心率變異性分析[J]. 中國實用神經疾病雜志, 2009, 12(14): 12-15.
20. 　Guzzetti S, Piccaluga E, Casati R, et al. Sympathetic predominance in essential hypertension: a study employing spectral analysis of heart rate variability[J]. J Hypertens, 1988, 6(9): 711-717.
21. 　隋敏生，王良玉，張鈺. 高血壓病心率變異性與臨床心血管事件發生的關系的研究[J]. 現代預防醫學, 2005, 32(8): 906-907.
22. 　Sucharita S, Bantwal G, Idiculla J, et al. Autonomic nervous system function in type 2 diabetes using conventional clinical autonomic tests, heart rate and blood pressure variability measures[J]. Indian J Endocrinol Metab, 2011, 15(3): 198-203.
23. 　de Jong MJ, Randall DC. Heart rate variability in the assessment of autonomic function in heart failure[J]. J Cardiovasc Nurs, 2005, 20(3): 186-195.
24. 　Ahmad S, Tejuja A, Newman KD, et al. Clinical review: a review and analysis of heart rate variability and the diagnosis and prognosis of infection[J]. Crit Care, 2009, 13(6): 232.
25. 　Fang SC, Cassidy A, Christiani DC. A systematic review of occupational exposure to particulate matter and cardiovascular disease[J]. Int J Environ Res Public Health, 2010, 7(4): 1773-1806.
26. 　Aerts MB, Synhaeve NE, Mirelman A, et al. Is heart rate variability related to gait impairment in patients with Parkinson’s disease? A pilot study[J]. Parkinsonism Relat Disord, 2009, 15(9): 712-715.
27. 　Tseng CD, Wang TL, Lin JL, et al. The mechanism of sympathovagal imbalance in patients with myocardial ischemia[J]. Jpn Heart J, 1996, 37(1): 43-58.
28. 　Routledge FS, Campbell TS, McFetridge-Durdle JA, et al. Improvement in heart rate variability with exercise therapy[J]. Can J Cardiol, 2010, 26(6): 303-312.

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