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【medical-news】睡眠呼吸暂停和心率变异性增高有
A sleep-related breathing disorder, common in heart failure, increases one's heart rate variability.
Further, central sleep apnea (CSA) and obstructive sleep apnea (OSA) produce different patterns of heart rate variability, which are likely to reflect the different pathophysiological mechanisms involved, according to a study published in the November 1 issue of the journal SLEEP.
Matthew T. Naughton, MD, of Alfred Hospital and Monash University in Melbourne, Australia, evaluated 21 patients with heart failure who were referred for polysomnography for investigation of a sleep-related breathing disorder. For each subject, two conditions were examined: a sleep-related breathing disorder and stable breathing.
There were three main findings of this study:
1.Within the subjects, the transition from stable breathing to a sleep-related breathing disorder was associated with an increase in heart rate variability, as well as an increase in the low frequency/high frequency ratio.
2.No difference in heart rate variability was found from samples taken from the beginning and end of the sleep period and, importantly, no evidence that cardiac autonomic regulation altered during the night independent of a sleep-related breathing disorder.
3.OSA and CSA produced different patterns of heart rate variability, with OSA showing increased absolute high frequency power and reduced very low frequency percentage compared with CSA.
"Heart rate patterns are influenced enormously by breathing patterns," said Dr. Naughton. "In heart failure patients during sleep, this information might be able to determine the presence or absence and type of sleep apnea. This could be useful in determining the stability of heart failure (and therefore predict a decline in heart function and signal when additional anti-heart failure therapies are required) and also signal when alternative therapies may be required (such as those directed towards treating OSA). Further work is required in this field."
OSA is a sleep-related breathing disorder that causes one's body to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the airway, preventing air from getting into the lungs.
CSA is a breathing disorder that causes one's body to decrease or stop the effort of breathing during sleep. This occurs in an off-and-on cycle. It is a result of a problem in the brain or heart. It is different from OSA because the problem is not caused by a blockage of the airway.
Scientific evidence shows that continuous positive airway pressure (CPAP) is the best treatment for sleep apnea. CPAP provides a steady stream of pressurized air to patients through a mask that they wear during sleep. This airflow keeps the airway open, preventing the pauses in breathing that characterize sleep apnea and restoring normal oxygen levels. CPAP users often express dramatic improvements in how they feel. They are more alert, have more energy and are able to perform at higher levels for longer periods of time.
http://www.news-medical.net/?id=32085 翻译： (中文翻译字数：846) 个人观点：
这篇报道所说的文章发表在美国睡眠医学学会的官方杂志《睡眠》上(2006SCI评分：5.126)，找了这篇报道翻译，弄了半天才发现文章主要讲的还是心内科的东西，有很多的专业词汇需要查，呵呵
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心率变异性（Heart rate variability HRV）是指窦性心率在一定时间内周期性改变的现象，是反应交感-副交感神经张力及其平衡的重要指标。HRV测定方法有两种，即时域测定法和频域分析法。HRV分析心电信号长短不一，短者分析5min或1h，长者可分析24h，甚至几天，国内外普遍采用24h法。时域法以RR间期的变异为基础，可用标准差、方差、极差、变异系数等来表达。常用指标：[1]SDNN：所有窦性RR间期的标准差。[2]SDNN Index:每5min窦性RR间期标准差的均值。[3]SDANN：每5min窦性RR间期均值的标准差。[4]r-MSSD：所有邻近窦性RR间期长度差异平方均值的平方根。[5]pNN50:50毫秒间隔以上临近周期的比例，单位为百分数。频谱分析法则是把心率变化信号分解为不同的频率成分并将其相对强度定量为功率，提供了各种频率成分的功率谱测定。常用指标有：[1]高频带（HF，0.15-0.40Hz）:有迷走神经介导，主要代表呼吸变异。[2]低频带（LF，0.04-0.15Hz）受交感神经和副交感神经共同影响。[3]极低频带（VLF，0.01-0.04Hz）：可作为交感神经活动的指标。[4]超低频带（ULF，1.15×10-5-0.0033Hz）：生理意义不明。[5]总频谱（TF）：是信号总的变异性。代表HF、VLF、ULF的总和。[6]LF/HF：代表交感-迷走神经张力的平衡状态。HRV的时域和频域测量是相关的，HF与r-MDSS、pNN50相关，LF、VLF与SDNN Index相关，ULF与SDNN、SDANN明显相关。
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作者:admin@医学,生命科学 2011-03-26 17:11
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