Day and night heart rate variability using 24-h ECG recordings: a systematic review with meta-analysis using a gender lens.

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Clinical Autonomic Research Pub Date : 2023-12-01 Epub Date: 2023-08-04 DOI:10.1007/s10286-023-00969-3
Beatrice De Maria, Monica Parati, Laura Adelaide Dalla Vecchia, Maria Teresa La Rovere
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Abstract

Purpose: Increasing evidence demonstrates that gender-related factors, and not only biological sex, are relevant in the physiological and pathophysiological mechanisms of the cardiovascular system, including the cardiac autonomic regulation. Sex and gender may also affect daytime and night-time cardiac autonomic control. This meta-analysis aimed to provide a comparison between healthy women and men on heart rate variability using 24-h ECG recordings pointing out sex- and gender-related factors.

Methods: A systematic search was conducted to include studies focusing on both sex and gender differences related to heart rate variability indices in the time and frequency domains. Descriptive data were extracted by two independent reviewers. For each index, standardized mean differences with 95% confidence intervals were computed and a pooled estimate using a fixed- or random-effects model was applied.

Results: Twenty-seven studies were included in the meta-analysis. The results showed that only seven studies reported some information about gender-related factors. Concerning sex-related differences, women had a shorter mean RR interval and lower variability of the time domain indices than men. Sex-related differences concerning frequency domain indices were more evident during night-time compared to daytime.

Conclusion: The characterization of gender-related factors in the study of heart rate variability using 24-h ECG recordings is still sporadic and underexplored. The meta-analysis results could not conclusively support a significant increase of high frequency power in women, although women showed a reduced total power and low frequency to high frequency ratio. There is a strong need for considering heart rate variability in relation to gender-related variables.

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使用 24 小时心电图记录的昼夜心率变异性:使用性别视角进行系统回顾和荟萃分析。
目的:越来越多的证据表明,与性别相关的因素,而不仅仅是生理性别,与心血管系统的生理和病理生理机制(包括心脏自主神经调节)有关。性和性别还可能影响白天和夜间的心脏自主神经控制。这项荟萃分析旨在利用 24 小时心电图记录对健康女性和男性的心率变异性进行比较,指出与性别相关的因素:方法:我们进行了系统性检索,以纳入与时域和频域心率变异性指数相关的性别差异研究。由两名独立审稿人提取描述性数据。对于每个指数,计算标准化平均差异和 95% 置信区间,并采用固定或随机效应模型进行汇总估计:荟萃分析共纳入了 27 项研究。结果显示,只有七项研究报告了一些与性别相关因素的信息。在性别差异方面,女性的平均 RR 间期比男性短,时域指数的变异性比男性低。与白天相比,夜间频域指数的性别差异更为明显:结论:在使用 24 小时心电图记录研究心率变异性时,与性别相关因素的特征描述仍是零星的,且未得到充分探索。尽管女性的总功率和低频与高频比值有所降低,但荟萃分析结果并不能确证女性的高频功率显著增加。因此很有必要考虑心率变异性与性别相关变量的关系。
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来源期刊
Clinical Autonomic Research
Clinical Autonomic Research 医学-临床神经学
CiteScore
7.40
自引率
6.90%
发文量
65
审稿时长
>12 weeks
期刊介绍: Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.
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