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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Loss of fractal heart rate dynamics in depressive hemodialysis patients.
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Loss of fractal heart rate dynamics in depressive hemodialysis patients.

机译：抑郁性血液透析患者的分形心率动态丧失。

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摘要

OBJECTIVE: To assess the relationship between depression, reduced heart rate (HR) variability, and altered HR dynamics among patients with end-stage renal disease who are receiving hemodialysis (HD) therapy. METHODS: We analyzed the 24-hour electrocardiograms of 119 outpatients receiving chronic HD. HR variability was quantified with the standard deviation of normal-to-normal R-R intervals, the triangular index, and the powers of the high- (HF), low- (LF), very-low (VLF), and ultra-low frequency (ULF) components. Nonlinear HR dynamics was assessed with the short-term (alpha(1)) and long-term (alpha(2)) scaling exponents of the detrended fluctuation analysis and approximate entropy. The depression level was assessed using the Beck Depression Inventory, Second Edition (BDI-II). HR variability and dynamics measurements were compared by gender, diabetes, and depression with adjustment for age and serum albumin concentration. RESULTS: Most indices of HR variability and dynamics were negatively correlated with age, serum albumin concentration, depression score, and were lower in women and patients with diabetes. The alpha(2) was inversely associated with these variables. Depressed men had significantly lower HF, LF, VLF, and marginally lower ULF than nondepressed persons after adjustment for diabetes and other covariates; no difference in depression was observed in women. The alpha(2) showed marginally significant difference in depression independent from gender and diabetes. CONCLUSIONS: Among the patients who received HD, depression is associated with reduced HR variability and loss of fractal HR dynamics. However, the influence of depression on HR variability may vary by gender and physiological backgrounds. Further prospective studies are necessary to confirm their association with poor prognosis.
机译：目的：评估接受血液透析（HD）治疗的终末期肾脏疾病患者抑郁，心率（HR）变异性降低和HR动态变化之间的关系。方法：我们分析了119例接受慢性HD的门诊患者的24小时心电图。 HR变异性通过正常至正常RR间隔的标准偏差，三角指数以及高（HF），低（LF），极低（VLF）和超低频的幂来量化（ULF）组件。非线性HR动态是通过趋势波动分析和近似熵的短期（alpha（1））和长期（alpha（2））缩放指数进行评估的。使用贝克抑郁量表第二版（BDI-II）评估抑郁水平。根据性别，糖尿病和抑郁情况，通过调整年龄和血清白蛋白浓度，比较了HR变异性和动态测量结果。结果：大多数HR变异性和动态指数与年龄，血清白蛋白浓度，抑郁评分呈负相关，在女性和糖尿病患者中较低。 alpha（2）与这些变量成反比。校正糖尿病和其他协变量后，抑郁症患者的HF，LF，VLF显着降低，而ULF显着低于非抑郁症患者。在女性中没有观察到抑郁的差异。 alpha（2）显示出与性别和糖尿病无关的抑郁症微差异。结论：在接受HD的患者中，抑郁症与HR变异性降低和HR分形动力丧失有关。然而，抑郁症对心率变异性的影响可能因性别和生理背景而异。有必要进行进一步的前瞻性研究，以确认它们与不良预后的关系。

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