研究限制與未來展望

七、結論及未來展望

7.2 研究限制與未來展望

本研究之主要目的為建立屬於台灣正常族群資料庫，以做為臨床診斷之重要參考依據。而本研究將實驗對象設定為二十至三十歲之間的學生族群，但是資料庫的建立應該還要包含其他年齡層才會較為全面。因為 HRV 會受到性別，年齡，以及種族的影響而有所改變，因此在未來的實驗中，可增加其他年齡層，希望可以建立以每十年分一個群群的龐大資料，其中包含小孩子以及老年人的資料。由於 HRV 會隨著年齡的上升而逐漸下降，因此，擴大年齡層範圍而使其更適用於臨床診斷。

本實驗之研究時間為早上八點至下午五點間進行測量，因其時間過長，因此未來可縮短研究時間以減少變因的發生。另外，本實驗以男女身高體重以及 BMI 進行測試時，發現其間有存在顯著性差異，因此建議未來的研究可依據 BMI 進行分組，

以確認男女差異是否由 BMI 的不同而影響。

然而其它會影響到 HRV 的因素有規律的運動，運動會改變 HRV。而觀察參與加本實驗之受試者之運動習慣有所不同，其中男性運動之比率大於女性，男女之間的差異也有可能由此產生，因此建議日後之研究可以增加比較有無運動之同年齡同性別之顯著差異是否存在。

生活作息可能造成的影響。於大學以上的學生其生活作息十分不同，甚至有些學生會有晚上工作白天休息的日夜顛倒之行為，這也嚴重影響到本研究之分析，因

此建議日後之研究可以比較日夜顛倒與正常生活學生之差異。也因為本研究只針對學生族群，其環境及生活步調較為平和，不能確定工作環境及工作壓力是否也是 HRV 的影響因素，因此也建議日後研究可增加上班族群，比較兩者間的異同處。讓此資料庫的建立更加完善，更加實用。

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附錄一實驗同意書

同意書

經過充分說明與溝通後，本人，身分證字號: ，瞭解整個實驗的狀況，並經過充份的考慮後，本人同意接受為交通大學生科學院所做的「正常台灣人心率變異性之研究」之自願受試驗者。

本人同意參加此研究並配合完成下列事項:

1. 配合為時五分鐘的測量，期間不走動及說話。

2. 配合實驗的臥姿、坐姿以及站姿之測量。

3. 配合十二導程標準心電圖之測試。

立同意書人簽名：

測試者簽名: 陳悅日期:民國年月日

附錄二 Poster of 17th Asian Pacific Congress of Cardiology

Dear Dr. Yueh Chen,

Thank you very much for submitting your following abstract to the 17th Asian Pacific Congress of Cardiology, which will beheld from May 20th to 23rd in Kyoto, Japan this year.

It is our great pleasure to inform you that our Organizing Committee has accepted your abstract for the Poster Session.

Title: "Frequency domain heart rate variability parameters are sex dependent in an apparently healthy taiwanese population"

We look forward to seeing you in Kyoto in May.

Respectfully yours,

Akira Kitabatake, MD., PhD, FACC,

Chairperson, 17th Asian Pacific Congress of Cardiology Akira Matsumori, MD, PhD,

Secretary General, 17th Asian Pacific Congress of Cardiology ---

Congress Secretariat:

Mizuki HIRASAWA (Ms.), Sayaka KAJI (Ms.) c/o Japan Convention Services, Inc.

E-mail: 17apcc@convention.co.jp FAX: +81-3-5283-5952

Congress Website: http://www.asiapacificardio.org/

Frequency domain heart rate variability parameters are sex dependent in an

apparently healthy Taiwanese population

Yueh Chen¹, Ching-Shiun Chang¹, Jia-Jun Lu¹, Ming-Ju Tsai¹, Yu-Shan Chen¹, Ing-Fang Yang^2,3, Ten-Fang Yang^1,3*

1 College of Biological Science and Technology, National Chiao Tung University,

Hsin-Chu City, Taiwan

2 Department of Internal Medicine, Jen-Chi General Hospital, Taipei city, Taiwan.

3 Institute of Biomedical informatics, Taipei Medical University, Taipei city, Taiwan.

Abstract:

Introduction: It has been reported that autonomic nervous system and

cardiovascular mortality are highly correlated. And heart rate variability (HRV) could reflect the modulation between sympathetic and parasympathetic nervous function.

Objectives: The aim of the present study is to analyze the gender differences

of short term (5 minutes) time domain and frequency domain HRV parameters in an apparently healthy Taiwanese population.

Materials and Methods: The study was performed at College of Biological

Science and Technology, National Chao Tung University from September 2008 to December 2008. A total of 100 healthy students from the university (50

males, aged 24 ± 3 years, and 50 females, aged 23 ± 2 years) without evidence of any heart disease by history and routine medical checkup were recruited for this study. The short term HRV recording was derived from the Modified Lead II-ECG, by a locally developed and manufactured device, D ailyCare BioMedical’s ReadMyHeart. All subjects were asked for lying, sitting, and standing for each 5-minute recording, and all of them must rest for at least 5 minutes before the measurement.

Conclusions: (1) There was a statistically significant sex difference in

frequency domain HRV parameters but not in time-domain parameters in all postures. (2) The high frequency component of female is greater than male in all postures. This might imply that parasympathetic tone in female is higher than that in male.

附錄三 Poster of 37th International Congress on Electrocardiology

Dear Yueh Chen,

Thank you for submitting an abstract to the 37th International Congress on Electrocardiology (ICE 2010), June 3–5, 2010, and to the Young Investigator Award Competition.

We are happy to inform you that your abstract: Postural changes influences on heart rate variability in an apparently healthy Taiwanese population, with abstract

number A0949, has been accepted for presentation during the conference.

Your abstract is currently being evaluated by the jury of the Young Investigator Award, therefore we can not present the exact time, date and type of your presentation.

We will give you this information as soon as we have received the jury results.

Please contact Malmö Kongressbyrå (Conference Agency) if you have any questions.

Most welcome to Lund in June!

Kind regards/

Lotta Ahlbertz

Malmö Kongressbyrå Phone: +46-40-258550 lotta@malmokongressbyra.se

Postural Changes Influences on Heart Rate Variability in an apparently healthy

Taiwanese population

Yueh Chen¹, Ching-Shiun Chang¹, Jia-Jun Lu¹, Ming-Ju Tsai¹, Yu-Shan Chen¹, Ing-Fang Yang^2,3, Ten-Fang Yang^1,3*

1 College of Biological Science and Technology, National Chiao Tung University,

Hsin-Chu City, Taiwan

2 Department of Internal Medicine, Jen-Chi General Hospital, Taipei city, Taiwan.

3 Institute of Biomedical informatics, Taipei Medical University, Taipei city, Taiwan.

Introduction:

Heart rate variability (HRV) analysis has been used for many years to measure ANS activities for its simplicity, accuracy, and noninvasiveness. Recent studies show that HRV may be a powerful technique to measure the modulation and balance between parasympathetic nervous system (PNS) and sympathetic nervous system (SNS)by time and frequency domain analysis. It’s believed that decreased HRV is a sign of autonomic imbalance, which may be caused by diseases, and with aging, the HRV decreases. Gender specific normal limits of HRV should be established to distinguish the normal decrease of HRV from pathological decreases in diseased conditions. The aim of the present study is to analyze the posture differences of short term (5 minutes) time domain and frequency domain HRV parameters in an apparently healthy

Taiwanese population.

Materials and Methods: The study was performed at College of Biological Science and Technology, National Chao Tung University from September 2008 to December 2009. A total of 115 healthy students from the university (57 males, aged 24 ± 1 years,

and 58 females, aged 23 ± 5 years) without evidence of any heart disease by history and routine medical checkup were recruited for this study. The short term HRV recording was derived from the Modified Lead II-ECG, by a locally developed and manufactured device, DailyCare BioMedical’s ReadMyHeart. All subjects were asked for lying, sitting, and standing each for 5-minute recording, and all of them must rest for at least 5 minutes before the measurement.

Results: The statistically significant results differences from lying to sitting, lying to standing, and sitting to standing and the difference between genders on different postures were demonstrated. SDNN and RMSSD also decreased from lying to standing(P≧ 0.01, table 1), except lying to sitting of SDNN(P＞0.05). Total power, representing the autonomic tone, also declined from lying to standing (P ≧ 0.01, table 2 and 3), except lying to sitting. Both the HF and HF norm decreased from lying to standing (P ≧ 0.05). The LF norm and LF/HF ratio increased from lying to standing (P≧ 0.01).

Conclusions:

(1) There was a statistically significant posture difference in both time and frequency domain HRV parameters.

(2) The results show that different postures strongly effect the autonomic tone from lying to standing. The HF component of the lying is greater than standing, this means that higher activity of parasympathetic tone while lying.

Table 1: Relationship of posture to HRV of time domain. (It’s significant differences

在文檔中正常台灣族群心率變異性之性別與姿勢差異 (頁 83-102)

七、 結論及未來展望