Research on the correlation between heart rate variability and cranial imaging lesions in cerebral small vessel disease

LI Ke-xian; PU Qiang; QI De-qing

doi:10.3969/j.issn.1672-5301.2024.10.006

Abstract：Objective To explore the correlation between autonomic nervous system function reflected by heart rate variability(HRV)and cerebral imaging lesions of small vessel disease.Method A total of 180 patients were included,including 137 patients diagnosed with cerebral small vessel disease(CSVD)and 43 patients without CSVD who visited Wudang Hospital affiliated to Guizhou Medical University from January 2022 to June 2023.According to the presence or absence of lesions and lesion burden on cranial MRI,they were divided into three groups:43 cases in the non CSVD group(no abnormal lesions on cranial imaging),36 cases in the CSVD low burden group(white matter ischemia or brain atrophy on cranial imaging)and 101 cases in the CSVD high burden group(white matter ischemia combined with brain atrophy on cranial imaging).The differences in baseline data and heart rate variability among the three groups were compared to explore and analyze the correlation between heart rate variability and ischemic lesions in cerebral small vessel disease on cranial imaging.Result Three sets of baseline data showed statistically significant differences in age and hypertension[(73.22±9.27)years vs.(61.11±8.02)years vs.(50.88±8.02)years;88(87.13％)cases vs.28(77.78％)cases vs.27(62.79％)cases,all P＜0.05].BMI and hemoglobin in the CSVD high load group were respectively lower than in the low load group and non CSVD group[(23.13±3.63)kg/m2 vs.(23.27±3.53)kg/m2 vs.(25.00±3.41)kg/m2;135.00(121.00,144.00)g/L vs.137.00(129.00,149.00)g/L vs.144.00(135.50,153.50)g/L,all P＜0.05].Three sets of HRV parameters showed that SDNN index,HF and LF in the high load group were all lower than those in the CSVD low load group and in the non CSVD group.The SDNN index of the three groups were 47.00(40.00,62.00),47.00(38.75,54.50)and 40.00(32.00,49.00),while HF was 169.30(108.55272.05),167.50(94.70,284.38)and 92.50(64.00,257.60)and LF were 347.00(240.40541.90),308.45(195.55,487.53)and 214.40(118.10,351.80),with statistically significant differences(P＜0.05).Univariate logistic regression analysis showed that after adjusting for age,hypertension,BMI and hemoglobin,the SDNN index(OR=0.970,95％CI 0.946-0.995,P=0.021),HF(OR=0.996,95％CI 0.992-0.999,P=0.022)and LF(OR=0.997,95％CI 0.995-0.999,P=0.003)still had statistical significance.Multivariate logistic regression analysis showed that after adjusting for age,hypertension,BMI and hemoglobin,only LF(OR=0.998,95％CI 0.995-1000,P=0.048)had statistical significance.Conclusion LF is an independent influencing factor of the severity of CSVD brain lesions in heart rate variability,and autonomic nervous system dysfunction is involved in the occurrence and development of CSVD brain lesions.