以短时心率变异性反映充血性心力衰竭患者自主神经活动的改变

doi:10.3969/j.issn.0258-8021.2016. 02.005

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Abstract This study is aimed to investigate the autonomic modulation and influence in patients with congestive heart failure (CHF) based on shortterm heart rate variability (HRV) analysis. One dataset from THEW as normal controls (n=189) and two datasets of CHF patients from PhysioNet were selected in this study. According to NYHA class, 44 CHF patients were divided into mild CHF group (NYHA I-II, n=12) and severe CHF group (NYHA III-IV, n=32). Two 5 minute episodes of RR interval (RRI), representing day and night in resting state, were selected in each Holter record. Then, time domain analysis, AR model based frequency domain analysis and detrended fluctuation analysis (DFA) were calculated in each series. The results demonstrated that there were significant differences for shortterm fractal scaling exponent in the day ((α₁)_d) in any two groups among normal controls, mild CHF group and severe CHF group. Moreover, the declining trend of (α₁)_d (1.35±0.21, 1.03±0.29 and 0.81±0.29, respectively) showed the change of heart rate dynamics from fractal properties towards random structure. In the meanwhile, significant differences existed for HFn in the day ((HFn)_d) in any two groups among the abovementioned three groups. And the sustained increase of (HFn)_d(23.89%±12.78%, 37.22%±11.24% and 56.30%±15.28%, respectively) suggested the loss of reciporcal function between sympathetic and vagal branches. Using RRIn(night RRI), (HFn)_dand (α₁)_d, the sensitivity and specificity for discriminating normal people and CHF patients reached 90.91% and 92.06%; Moreover, the sensitivity and specificity for discriminating mild CHF patients and severe CHF patients were 84.38% and 100%. Combining nonlinear analysis and traditional methods, our results provided the basis for clinical use of HRV in monitoring the progress of CHF and testing therapeutic effects.

Key words： heart rate variability (HRV) congestive heart failure (CHF) detrended fluctuation analysis (DFA) autonomic nervous system (ANS)

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	Liu Hongduoer Zhan Ping Wang Zhigang Peng Yi^#*

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Liu Hongduoer Zhan Ping Wang Zhigang Peng Yi^#*. Short-Term Heart Rate Variability for Assessment of Autonomic Nervous Activity in Patients with Congestive Heart Failure[J]. journal1, 2016, 35(2): 155-161.

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http://cjbme.csbme.org/EN/10.3969/j.issn.0258-8021.2016. 02.005 OR http://cjbme.csbme.org/EN/Y2016/V35/I2/155

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