运动后心率恢复与心率变异性的关系

摘要

目的 观察短期(5 min)心电图心率变异性(HRV)与运动后心率恢复(HRR)之间的相关性.方法 对495例患者按年龄分为老年组106例和年轻组389例进行活动平板运动试验并评估其短期HRV,观察正常到正常时间间隔的标准差[SDNN]、正常到正常时间间隔的平均方差的平方根[RMSSD]、正常到正常时间间隔超过50 ms的病例数[NN50 count]、正常到正常时间间隔总数除以NN50的百分比[pNN50]以及低频[LF]、高频[HF]、总功率)范围.结果 老年组:试验后4 min时HRR[(54±13)与(60±12)] beats/min,P =0.003是运动结果阳性的最显著指标.年轻组:时间范围检测(SDNN:相关系数0.34,P＜0.001;RMSSD:相关系数0.37,P＜0.001)和频率范围(LF:相关系数0.21,P＜0.001；HF:相关系数0.13,P=0.01；总功率:相关系数0.22,P＜0.001)都与4 minHRR有显著相关性.结论 在年轻患者中接受活动平板运动试验后4 min时的HRR与时间域和频域的短期HRV相关,但在老年患者中并非如此.%Objective To observe the relationship between short-term heart rate variability(HRV) and heart rate recovery (HRR) after exercise.Methods 495 patients (273 men),whose age ranged 19-85 years,were submitted to treadmill exercise tests and short-term HRV evaluations.The standard deviation of the normal-to-normal interval (SDNN),the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD),the number of interval differences of successive normal-to-normal intervals greater than 50 ms (NN50 count),the proportion derived by dividing NN50 count by the total number of normal-to-normal intervals (pNN50) and frequency(lowfrequency power,high-frequency power,total power) domains were observed.Results Among 495 patients,106 patients(68 men) were elderly(age≥65 years).Male gender and hypertension were significantly higher in elderly patients.The young patients had higher HRR after exercise.HRR at 4min (54 ± 13) vs (60 ± 12) beats/min,P =0.003 was the most significant predictor for positive exercise test result.In the young group,both time domain measures (SDNN:correlation coefficient 0.34,P ＜ 0.001 ; RMSSD:correlation coefficient 0.37,P ＜ 0.001) and frequency domain measures (LF:correlation coefficient 0.21,P ＜ 0.001 ; HF:correlation coefficient 0.13,P =0.01 ; total power:correlation coefficient 0.22,P ＜ 0.001) were significantly associated with HRR at 4min.Conclusion HRR at 4min was significantly associated with short-term HRV of time and frequency domains in young individuals,but not elderly ones,who received treadmill exercise test.