Effect Of Heart Rate Variability On White Matter Lesions In The Elderl

BackgroundWhite matter lesions(WML)refers to the high signal on T2 and FLAIR phase of magnetic resonance or the low signal on computed tomography in the paraventricular or deep white matter of the brain.It is commonly seen in the elderly and is associated with stroke,cognitive impairment,dementia,senile syndrome and other diseases.The etiology of WML is related to vascular disease,infection,aging,heredity and other factors.Vascular diseases,including cerebrovascular diseases,arteriosclerosis,venous system diseases,vascular aging,etc.,may be the most important causes of WML.Therefore,both classical and non classical risk factors of cardiovascular and cerebrovascular diseases are related to the onset of WML,but the relationship of some of these risk factors is controversial.As a non classical risk factor of cardiovascular disease,heart rate variability(HRV)has attracted much attention in recent years.In previous studies,different conclusions have been drawn on the impact of different HRV indicators on the location and severity of WML,and the true relationship between HRV and WML still needs further research to confirm.ObjectiveThe purpose of this study is to explore whether and to what extent HRV linear indicators are related to WML in the elderly over 60 years old,and to further explore the independent influencing factors of WML in different parts of the elderly by using the collected demographic,laboratory examination and other data,and to reveal the reasons for the development of WML in the elderly.Materials and methodsThe demographic,dynamic electrocardiogram and imaging data of 193 elderly patients over 60 years old in Department of Neurology,Jinan Central Hospital were collected retrospectively.The patients were divided into mild and severe groups according to DWML and PWML scores,and were statistically analyzed with SPSS Vor.26.0.0.0.First,statistical description of the data taken.With each HRV index as the regression target,linear regression analysis was used to screen the factors affecting the HRV of the study population according to the criteria of p>0.05 exclusion.After the patients were divided into deep white matter lesions(DWML)and periventricular white matter lesions(PWML)groups,the quantitative data were compared with the t-test of two independent samples,and the qualitative data were compared with the chi square test to test whether there were significant differences between the mild group and the severe group in various indicators.Then the patients were paired according to the factors that have significant impact on HRV,and the HRV indicators between groups were tested for significant differences.With DWML score and PWML score as dependent variables and p-value as indicators with statistical significance,orderly regression coefficients were calculated.The independent risk factors of WML were finally obtained by using the regression method to exclude the lowest value of regression coefficient p each time.P<0.05(bilateral)was considered statistically significant.Results1.The history of diabetes has linear correlation with SDNN(p=0.007)and SDANN(p=0.002);There was a linear correlation between age and SDNN(p=0.019),rMSSD(p=0.012),VLF(p=0.005),LF/HF(p=0.001);Smoking was associated with increased LF/HF(p=0.047);Men were associated with elevated LF/HF(p<0.001).2.After matching the patients according to the factors that have influence on HRV,each linear index monitored by HRV in 24 hours has no independent correlation with WML of each part.3.The severe group of DWML was older than the mild group(p=0.016),and the prevalence of hypertension(p=0.016)and IHD(p<0.001)was higher.Ordered regression analysis showed that high homocysteine(Hcy)(p=0.015),hypertension history(p=0.008)and ischemic heart disease(IHD)history(p<0.001)were independently related to DWML score.4.The PWML severe group was older than the mild group(p=0.030),and the prevalence of hypertension(p=0.032)and IHD(p=0.040)was higher.An ordered retrospective analysis showed that age(p=0.020)and hypertension history(p=0.016)were independently associated with PWML scores.Conclusion.1.The intensity of sympathetic and vagal innervation of the heart and the sympathetic vagal balance have no impact on the severity of WML.2.Among the elderly aged over 60,there is a linear negative correlation between age and some indicators in HRV;Age is an independent risk factor for increased PWML scores and is associated with increased DWML.3.The sympathetic and vagal functions of diabetes patients are low,but whether they have diabetes has nothing to do with the severity of WML in each part.HRV changes in elderly hypertensive patients are not significant,and hypertension is an independent risk factor for both PWML and DWML exacerbation.Impaired cardiac autonomic nervous function in patients with IHD,and the prevalence of IHD is an independent risk factor for exacerbation of DWML.