...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The prognostic value of heart rate variability in the elderly, changing the perspective: From sympathovagal balance to chaos theory
【24h】

The prognostic value of heart rate variability in the elderly, changing the perspective: From sympathovagal balance to chaos theory

机译：老年人心率变异性的预后价值，改变观点：从交感神经平衡到混沌理论

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Heart rate variability (HRV) is the temporal beat-to-beat variation in successive RR intervals on an electrocardiographic (ECG) recording and it reflects the regulation of the heart rate (HR) by the autonomic nervous system (ANS). HRV analysis is a noninvasive tool for the assessment of autonomic function that gained momentum in the late 1980s when its clinical relevance as a predictor of mortality was established by a milestone study by Kleiger et al. in patients with postacute myocardial infarction. In the last few decades, the increasing availability of commercial ECG devices offering HRV analysis has made HRV a favorite marker for risk stratification in the setting of cardiovascular disease. The rapid aging of the world population and the growing popularity of HRV have also fueled interest for the prognostic value of HRV in the elderly, outside a specific cardiological context. However, the discussion of HRV measures in the elderly is still very much centered on the rather reductionistic model of sympathovagal balance, with the orthosympathetic and parasympathetic limbs of the ANS exercising opposing effects on the heart via autonomic tone. The expanding application of nonlinear dynamics to medicine has brought to the forefront the notion of system complexity, embedded in the mathematical concepts of chaos theory and fractals, and provides an opportunity to suggest a broader interpretation for the prognostic significance of HRV, especially in the elderly. Although the use of novel indices of HRV may be hampered by practical issues, a more holistic approach to HRV may still be safeguarded if traditional time- and frequency-domain measures are viewed in terms of autonomic modulation. This review focuses on HRV in geriatric populations. It considers studies on the prognostic value of HRV in elderly subjects, discussing the potential confounding effect of erratic rhythm, and concentrates on the conceptual distinction between autonomic tone and autonomic modulation. It also briefly addresses the question of the practicality of ECG recordings and identifies a promising area for future research in the effects of common noncardioactive drugs on HRV. (PACE 2012;00:1-17)
机译：心率变异性（HRV）是心电图（ECG）记录上连续RR间隔的逐次心跳变化，它反映了自主神经系统（ANS）对心率（HR）的调节。 HRV分析是一种用于评估自主神经功能的非侵入性工具，该功能在1980年代后期得到了发展，当时Kleiger等人进行了一项里程碑式的研究，确立了其作为死亡率预测指标的临床意义。急性心肌梗死后的患者。在过去的几十年中，提供HRV分析的商用ECG设备的可用性不断提高，使HRV成为心血管疾病背景下风险分层的最爱标记。世界人口的迅速老龄化和HRV的日益普及也激发了人们对HRV在特定心脏病背景之外的预后价值的兴趣。但是，关于老年人HRV措施的讨论仍主要集中在交感迷走平衡的简化模型上，ANS的正交感和副交感肢体通过自主神经对心脏产生相反的影响。非线性动力学在医学中的广泛应用使系统复杂性这一概念成为最重要的问题，它被嵌入混沌理论和分形的数学概念中，并提供了一个机会，可以对HRV的预后意义（尤其是对老年人）进行更广泛的解释。尽管使用HRV的新指标可能会受到实际问题的阻碍，但是，如果从自主调制的角度看待传统的时域和频域测量方法，仍然可以维护更全面的HRV方法。这篇综述着重于老年人群的HRV。它考虑了对HRV在老年受试者中的预后价值的研究，讨论了不稳定节奏的潜在混杂效应，并着重于自主音和自主调节之间的概念区别。它还简要介绍了心电图记录的实用性问题，并确定了未来的研究领域，以研究常见的非心脏活性药物对HRV的影响。 （PACE 2012; 00：1-17）

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号