在衰老过程中自主心脏调节的变化和预后意义
Elisa Karhumaa1, Antti Vuoti1, Antti M Kiviniemi1
1Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
Autonomic neuroscience : basic & clinical
|March 2, 2025
概括
心率变化 (HRV) 随着年龄的增长而下降,特定HRV指标的较大下降预测死亡率. 这些发现强调了HRV.
科学领域:
- 心脏病学 心脏病学
- 老年学是一门学科.
- 生理学 生理学 生理学
背景情况:
- 关于心率变化 (HRV) 变化和衰老期间预后意义的数据有限.
- 衰老与心脏自主调节的改变有关,影响心血管健康.
- 了解这些变化对于预测老年人的健康结果至关重要.
研究的目的:
- 为了在显著的随访期内调查各种心率变化 (HRV) 参数的纵向变化.
- 确定基线HRV的预后值及其在预测总和心血管死亡率方面的变化.
- 评估衰老对心脏自主功能的影响,如HRV所反映.
主要方法:
- 从1991-1993年和2013-2014年对783个人的队列中ECG记录的纵向分析.
- 使用时间域,频域和非线性方法进行HRV分析 (包括阻滞波动分析 - DFA1,近似 - ApEn).
- 采用多变量统计模型来评估2021年审查的死亡终点HRV参数的预测值.
主要成果:
- 在大约22年的时间里,大多数HRV参数,包括高频 (HF),低频 (LF),非常低频 (VLF) 功率,RR间隔的标准偏差 (SDNN),DFA1和ApEn的统计学显著下降.
- 较大降低VLF (自然对数 - VLF(ln)) 和LF (自然对数 - LF(ln)) 显著预测总和心血管 (CV) 死亡率.
- 在临床调整后,基线LF (ln) (二切切) 和DFA1显示了总和心血管死亡率的最强的预后值.
结论:
- 心率变化 (HRV) 参数通常随着年龄的增长而下降,反映出心脏自主调节的减弱.
- VLF (ln) 和LF (ln) 的下降率提供了关于总和心血管死亡率的重要预后信息.
- 基线LF (ln) 和DFA1成为死亡率的关键预测指标,强调了它们在评估老龄化人口的长期健康结果方面的重要性.
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