Aim:Myasthenia gravis(MG)is a neuromuscular transmission disorder caused by acetylcholine receptor autoantibodies.Cardiac autonomic dysfunctions were rarely reported in patients with MG.Functional cardiac abnormalitie...Aim:Myasthenia gravis(MG)is a neuromuscular transmission disorder caused by acetylcholine receptor autoantibodies.Cardiac autonomic dysfunctions were rarely reported in patients with MG.Functional cardiac abnormalities were variable and reported in patients at severe stages of the disease and with thymoma.We investigated cardiac functions in patients with MG using Ambulatory 24‑h electrocardiographic Holter‑Monitoring.Methods:This study included 20 patients with MG with a mean age of 28.45±8.89 years and duration of illness of 3.52±1.15 years.The standard Holter reports include data for heart‑rate,ventricular ectopies(VEs),supraventricular ectopies(SVEs),heart-rate variability(HRV),ST,QT,atrial fibrillation and T‑wave alternans.Results:VEs,SVEs and ST‑T changes were reported in 55%,40%and 20%of patients respectively.Compared with healthy subjects(n=20),HRV components including SDNN,SDANN,SDNN Index,RMS‑SD and pNN50(P=0.001 for all)were reduced in patients indicating sympathetic and parasympathetic autonomic dysfunctions.HRV abnormalities were reported in 30-60%of patients.No significant correlations were identified between SDNN,RMS‑SD,pNN50,and duration of illness.Conclusion:Depressed HRV may be an early manifestation of autonomic neuropathy in patients with MG even in milder stages of the disease.This information is useful in rating disease progression and the efficacy of therapeutic interventions.展开更多
The Karvonen formula, which is widely used to estimate exercise intensity, contains maximum heart rate, H Rmax, as a variable. This study employed pedaling experiments to assess which of the proposed formulas for calc...The Karvonen formula, which is widely used to estimate exercise intensity, contains maximum heart rate, H Rmax, as a variable. This study employed pedaling experiments to assess which of the proposed formulas for calculating H Rmaxwas the most suitable for use with the Karvonen formula. First, two kinds of experiments involving an ergometer were performed: an all-in-one-day experiment that tested eight pedaling loads in one day, and a one-load-per-day experiment that tested one load per day for eight days.A comparison of the data on 7 subjects showed that the all-in-one-day type of experiment was better for assessing H Rmaxformulas,at least for the load levels tested in our experiments. A statistical analysis of the experimental data on 47 subjects showed two of the H Rmaxformulas to be suitable for use in the Karvonen formula to estimate exercise intensity for males in their 20 s. In addition, the physical characteristics of a person having the greatest impact on exercise intensity were determined.展开更多
基于心率变异性(HRV)的特征分析,提出一种患者阵发性房颤(PAF)发作的预测系统方法。首先,基于一种新的自适应滤波技术逐次平滑滤波并粗粒化HRV后,采用熵量化HRV在多个自适应尺度的复杂性特征;其次,特征经MinMax归一化和序列前向选择特...基于心率变异性(HRV)的特征分析,提出一种患者阵发性房颤(PAF)发作的预测系统方法。首先,基于一种新的自适应滤波技术逐次平滑滤波并粗粒化HRV后,采用熵量化HRV在多个自适应尺度的复杂性特征;其次,特征经MinMax归一化和序列前向选择特征子集,输入支持向量机识别HRV类型,预测PAF发作。经50例时长5 min HRV序列集的五折交叉验证,得到最优预测结果为:准确率98%,敏感性100%,特异性96%,性能表现优越。另外,实验表明远离和紧随PAF时的HRV复杂性特征值在不同频率段内,分别具有不同的显著变化(P<0.05),反映受试者神经系统调节心脏节律改变,以及调控机体、应激等适应外界环境变化能力的下降。展开更多
目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是...目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。展开更多
为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心...为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心率均较静息时明显升高,心率变异性指标中SDNN(Standard deviation of NN intervals,RR间期标准差)下降、LF/HF(low frequency/high frequency,低高频比值)升高,反映样本群体在精神压力应激时心脏交感副交感神经失衡。通过远程心电监测,发现科技工作者在居家时存在异常心电活动,包括各类心律失常、心电图ST-T改变(ST为心室肌除极过程,T为心室肌复极过程)等。基于以上结果,建议定期给科技工作者提供心脏心理的检测,必要时提供远程的心电监测,及时发现科技工作者的心脏心理问题,对有必要进行干预的人员,及早提供干预措施,以保障科技工作者的心脏心理健康。展开更多
文摘Aim:Myasthenia gravis(MG)is a neuromuscular transmission disorder caused by acetylcholine receptor autoantibodies.Cardiac autonomic dysfunctions were rarely reported in patients with MG.Functional cardiac abnormalities were variable and reported in patients at severe stages of the disease and with thymoma.We investigated cardiac functions in patients with MG using Ambulatory 24‑h electrocardiographic Holter‑Monitoring.Methods:This study included 20 patients with MG with a mean age of 28.45±8.89 years and duration of illness of 3.52±1.15 years.The standard Holter reports include data for heart‑rate,ventricular ectopies(VEs),supraventricular ectopies(SVEs),heart-rate variability(HRV),ST,QT,atrial fibrillation and T‑wave alternans.Results:VEs,SVEs and ST‑T changes were reported in 55%,40%and 20%of patients respectively.Compared with healthy subjects(n=20),HRV components including SDNN,SDANN,SDNN Index,RMS‑SD and pNN50(P=0.001 for all)were reduced in patients indicating sympathetic and parasympathetic autonomic dysfunctions.HRV abnormalities were reported in 30-60%of patients.No significant correlations were identified between SDNN,RMS‑SD,pNN50,and duration of illness.Conclusion:Depressed HRV may be an early manifestation of autonomic neuropathy in patients with MG even in milder stages of the disease.This information is useful in rating disease progression and the efficacy of therapeutic interventions.
基金supported by Health Science Center Foundation,Japan
文摘The Karvonen formula, which is widely used to estimate exercise intensity, contains maximum heart rate, H Rmax, as a variable. This study employed pedaling experiments to assess which of the proposed formulas for calculating H Rmaxwas the most suitable for use with the Karvonen formula. First, two kinds of experiments involving an ergometer were performed: an all-in-one-day experiment that tested eight pedaling loads in one day, and a one-load-per-day experiment that tested one load per day for eight days.A comparison of the data on 7 subjects showed that the all-in-one-day type of experiment was better for assessing H Rmaxformulas,at least for the load levels tested in our experiments. A statistical analysis of the experimental data on 47 subjects showed two of the H Rmaxformulas to be suitable for use in the Karvonen formula to estimate exercise intensity for males in their 20 s. In addition, the physical characteristics of a person having the greatest impact on exercise intensity were determined.
文摘基于心率变异性(HRV)的特征分析,提出一种患者阵发性房颤(PAF)发作的预测系统方法。首先,基于一种新的自适应滤波技术逐次平滑滤波并粗粒化HRV后,采用熵量化HRV在多个自适应尺度的复杂性特征;其次,特征经MinMax归一化和序列前向选择特征子集,输入支持向量机识别HRV类型,预测PAF发作。经50例时长5 min HRV序列集的五折交叉验证,得到最优预测结果为:准确率98%,敏感性100%,特异性96%,性能表现优越。另外,实验表明远离和紧随PAF时的HRV复杂性特征值在不同频率段内,分别具有不同的显著变化(P<0.05),反映受试者神经系统调节心脏节律改变,以及调控机体、应激等适应外界环境变化能力的下降。
文摘目的 探讨收缩压变异性(SBPV)和心率变异性(HRV)对维持性血液透析(MHD)患者主要不良心血管事件(MACE)发生风险的预测价值。方法 纳入2017年3月—2018年3月在宜昌市中心人民医院肾病内科血液净化中心接受规律治疗的MHD患者120例,根据是否发生MACE分为MACE组(n=59)与无MACE组(n=61)。在患者行血液透析前佩戴Holter,收集24 h心电活动信息,计算均值(MEAN)、RR间期总体标准差(SDNN)、RR间期平均值的标准差(SDANN)和相邻RR间期差值的均方根(r-MSSD)。采用自动血压监测系统记录24 h血压变化,计算白昼收缩压变异性(dSBPV)、夜间收缩压变异性(nSBPV)和24 h收缩压变异性(24 h SBPV)。Logistic回归分析MHD患者MACE发生的危险因素。调整混杂因素后,采用Cox比例风险模型回归分析24 h SBPV和SDNN与MHD患者MACE发生的关系。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC)、灵敏度、特异度,分析SDNN和收缩压变异性单独及联合对维持性MHD患者发生MACE的预测价值。根据SDNN和24 h SBPV水平将患者分成3组,绘制Kaplan-Meier生存曲线评价不同SDNN和收缩压变异性的MHD患者MACE发生情况。结果 与无MACE组相比,MACE组年龄较大,24 h SBPV、dSBPV、nSBPV较高,SDNN、SDANN较低,差异具有统计学意义(P<0.05)。Logistic回归分析显示,年龄、Kt/V、24 h SBPV、dSBPV、nSBPV、SDNN、SDANN是MHD患者MACE发生的独立危险因素(P<0.05)。调整混杂因素后,多因素COX比例风险模型回归分析,24 h SBPV为MHD患者发生MACE的危险因素,而SDNN为MHD患者发生MACE的保护性因素(P<0.05)。SDNN与收缩压变异性联合预测MHD患者发生MACE的AUC为0.879,预测效能高于单项检测(P<0.05)。组1随访期间累积MACE发生率显著低于组2和组3(19.15%vs 65.12%vs 73.33%,P<0.001)。结论 MHD不良预后患者中24 h SBPV升高,SDNN降低,24 h SBPV和SDNN单独预测MACE的具体价值尚可,两者联合预测效果更佳,可为临床上及早识别及干预MHD患者MACE发生提供参考依据。
文摘目的探究双相情感障碍(BD)与广泛性焦虑障碍(GAD)人群之间的心率变异性(HRV)的差异。方法将57例BD患者(BD组)和60例GAD患者(GAD组)分别开展HRV检测,并对两者的心率变异相关指标24 h全程NN间期的标准差(SDNN-24)、全程NN间期的标准差(SDNN)、全程每5 min NN间期平均值的标准差(SDANN)、全部相邻NN之差的均方根(rMSSD)、相邻NN之差>50 ms的个数占总窦性心搏个数的百分比(PNN50)、总功率(TP)、低频(LF)、高频(HF)、LF与HF之间的比值(LF/HF)结果进行组间统计差异比较。结果GAD组病程短于BD组(P<0.01)。GAD组的时阈指标SDNN-24、SDANN低于BD组(P<0.01)。相关分析结果显示,GAD组病程与TP、LF、HF、SDNN均呈负相关(P<0.05)。结论GAD的自主神经功能失调要比BD患者更加严重;GAD患者的病程会影响其HRV频阈指标。
文摘为研究北京市科技工作者精神压力与心脏损伤的关系,以155名北京市科技工作者为研究对象,测量相关指标。结果表明,样本群体中心血管疾病占比20.6%,抑郁占比35.9%,焦虑占比24.8%,失眠占比38.8%。在应对精神压力应激时,科技工作者血压、心率均较静息时明显升高,心率变异性指标中SDNN(Standard deviation of NN intervals,RR间期标准差)下降、LF/HF(low frequency/high frequency,低高频比值)升高,反映样本群体在精神压力应激时心脏交感副交感神经失衡。通过远程心电监测,发现科技工作者在居家时存在异常心电活动,包括各类心律失常、心电图ST-T改变(ST为心室肌除极过程,T为心室肌复极过程)等。基于以上结果,建议定期给科技工作者提供心脏心理的检测,必要时提供远程的心电监测,及时发现科技工作者的心脏心理问题,对有必要进行干预的人员,及早提供干预措施,以保障科技工作者的心脏心理健康。
