Amaç: Kalp hızı değişkenliği (KHD), otonom sinir sistemi dinamiklerini değerlendirmede kullanılabilecek bir dizi parametreden oluşmaktadır. KHD'nin yaşa göre ve cinsiyetler arasında farklılık gösterdiği biliniyorken; cinsiyetler arasındaki farklılığın yaş ilerledikçe gösterdiği seyir hakkında yeterli veri bulunmamaktadır. Çalışmamızda, sağlıklı kadınlar ve erkeklerdeki KHD parametrelerinin, yaşa göre değişimini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışma; 01.01.2016 tarihinden 30.01.2018 tarihine kadar Eskişehir Osmangazi Üniversitesi Kardiyoloji Polikliniğine başvuran 1.833 hastanın geriye dönük 24 saatlik ambulatuvar Holter elektrokardiyogram verilerinin incelenmesi ile gerçekleştirildi. Sağlıklı bireyler olarak değerlendirilen ve 20 saatten uzun kaydı olan 477 kişi çalışmaya dâhil edildi. Hastaların dk'daki ortalama, minimum ve maksimum kalp hızı (KH), KHD parametrelerinden SDNN, SDNN indeks, rMSSD, pNN50, yüksek frekans [high frequency (HF)], düşük frekans [low frequency (LF)], çok düşük frekans değerleri, LF/HF oranları kaydedildi. Yaşa ve cinsiyete göre gruplar oluşturulduktan sonra istatistiksel analiz yapıldı. Bulgular: Hastaların, KHD parametreleri yaş gruplarına göre değerlendirildiğinde, tüm parametrelerde gruplar arasında istatistiksel olarak anlamlı düzeyde farklılık izlendi (p<0,001). KH dışında tüm parametreler, kadınlarda erkeklere göre düşük saptandı. Cinsiyetler arası farklılıkların ise 60 yaşından sonra tamamen ortadan kalktığı gözlendi. Sonuç: Çalışmamızda, yaş ilerledikçe hem KHD'de düşüklük olduğu hem de cinsiyetlere bağlı farklılıkların 60 yaşından sonra kaybolduğu gözlendi. Kadınlarda daha yüksek KH ve düşük KHD olmasına rağmen kalbin otonomik regülasyonu parasempatik sistem kontrolünde saptandı.
Anahtar Kelimeler: Kalp hızı değişkenliği; seks karakteristikleri; yaşlanma; kalp hızı
Objective: Heart rate variability (HRV) consist of parameters which can be helpful for assesment of autonomic nervous system dynamics. Whilst it is known that HRV varies according to age and between genders; there is scant data regarding how the sex differences run its course with age. We aimed to evaluate variation of gender differences in HRV with age in healthy humans. Material and Methods: This study was based on retrospective analysis of the data recorded by 24-hours ambulatory Holter electrocardiograms of around 1,833 patients, who applied to Cardiology Policlinics in Eskişehir Osmangazi University from 01.01.2016 to 30.01.2018. 477 subjects, who were assessed as healthy humans and had over 20 hours of recordings, were included. Mean, minimum and maximum heart rate (HR), SDNN, SDNN index, rMSSD, pNN50, high frequency (HF), low frequency (LF), very low frequency values, LF/HF ratios of patients were noted. Groups according to age and genders were created and statistical analysis was performed subsequently. Results: Statistically significant difference was observed between the groups according to age in all HRV parameters (p<0.001). All parameters except mean HR, were lower in women compared to men. It was observed that the differences in terms of gender completely disappeared after the age of 60. Conclusion: In addition to lower HRV parameters in older age groups; it was also observed that the differences according to gender completely vanished after the age of 60 in our study. Autonomic regulation of the heart was detected under the control of the parasympathetic system in women; despite the higher HR and lower HRV parameters.
Keywords: Heart rate variability; sex characteristics; aging; heart rate
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