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1. ..................................................................................................................
1.1 .....................................................................................
1.2 ...........................................................................................................
1.3 .................................................................
1.4 ..............................................
1.5 .........................................................
1.6 ............................................................................
1.7 ..................................................................................
1.8 ...............................................................................
2. ..................................
3. ......................................................................................
3.1 ...................................................
3.2 ,
..............................................................................................................
3.2.1 .......................................................................
3.2.2 ....................................................................................
3.2.3 .............................
3.3 ....................................................................................
3.3.1 ...........................................................
3.3.2 .........................................................
3.3.2.1 ...............................
3.3.2.2 .........................
3.3.2.3 ........
3.3.3 ................................
3.3.4 . . ..............
3.3.5 .......................................
3.4 ....................................
3.4.1 .................................................
3.4.2 .............................................................................
3.4.3 ............................................................
3.5 .............................................................................................
3.6 .........................................................................................
3.6.1 .................................................................................................................
3.6.2 ...............................
3.7 ...........
3.8 ......................................................
4. ............................................................................
4.1 ..............................................................
4.2 ........................................................................
4.3 ...............................................
4.4 .......................................
4.5 ..................................................................................................
4.6 ....................................................................
4.7 .................................................
4.8 ..............................................................................
4.9 ...................................................................

6
6
6
6
7
7
8
8
9
9
10
11
13
14
14
14
15
17
17
18
21
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23
24
26
27
28
28
31
34
35
35
35
36
37
40
43
43
46
49
49
50
51
53
53
53

5. ................................................................................................
5.1 ................................................................................................................
5.2 ................................................................................................
5.2.1 .......................................
5.2.2 ...................................................................
5.2.3 ...............................................................................
5.2.4 .....................................................................................................................
5.2.5 -
.........................................................................................................................
6. ...................................................................................................
6.1 ................................................................................................................
6.1.1 .............................................................
6.1.2 ..............................................
6.1.3 ...........................................................................................
6.2 ................................................................................................
6.2.1 ...................................................................
6.2.2 ......................................................................
6.2.3 ...................................................................................................
6.2.4 ....................................................................................
6.2.5 ...............................
6.2.6 ....................................................
6.2.7 ........................................................................
6.2.8 ........................................................................................
6.2.9 ........................................................
6.2.10 ...............................................
6.2.11 ........................
7. ...................
7.1
7.2 .......................................................................................................
7.3 ...............................................................................
7.4 .......................................................................................
7.5 ....................
8. ..............
8.1 ........................................................................
8.2 .....................................................
8.3 ..........................................
8.4 ......................
8.5 ....................
8.6 ..................
8.7 ...................................
8.8 ........................................
..............................................................................................................................
1. .............
2.
............................................................................................
3.
.........................................................................................
4. ......
5.
...........................................
......................................................................................................

55
55
57
57
57
58
60
60
61
61
61
62
63
64
64
66
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95
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99
101
102
102
105


.
, .

. . , . . . . . , , .
. , . . , . . , . . . . .
. . , . . ,
. . , . . , . . . . , -
. . . . .
. . , . . , . . , . . . . .





--

NYHA

New York Heart Associacion

1.
1.1
1932 , R-R [96]. 1965 . Hon Lee ,
[159].
1973 . Sayers . [189]. 80- Ewing . , , R-R-
[148]. , -

, 1978 . Wolf . [199]. 1981 . Acselrod . [129].



. . [48-52] ( ) . . ( , ) [8-17].
,
.
1996 . -
, , ,
[192].

-.
, . :
.
( ,
Q-T, . .) .
( ,
. .).
( , , . .).
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1996 , [192].
, heart rate variability
(HRV), () ().
, , R-R-,
. , , .
,
, . , RR : SDNN, SDRR, , CLV. 3. .
1.3

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X, Max, Min, . , D, , , As, Ex, V


, , , , , ,
TP, HF, LF, VLF, ULF, LF/HF, HF (%), LF (%),
VLF (%), ULF (%), HF n. u., LF n. u., ,
m 0, 1k
L, w, L/w, S,
RRNN, SDNN, rMSSD, NN50count, PNN50, HRV
W, WN1, WN5, WAM5, WAM10
m(RRM) (), m(), m() (%)

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10

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11


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.
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. 2, 2
, , .
. .
: , . 0,40-0,15 ,
(HF). , (LF), 0,15-0,04 [192].
: ,
, [96, 101]. - (-
, , .)
0,04-0,0033 , (VLF).




HF
LF
VLF
ULF

()
0,40-0,15
0,15-0,04
0,04-0,0033
0,0033

(.)
2,5-6,7
6,6-25
25-303
303

VLF .

[101]:
1. 0,15-0,40 - ;
2. 0,07-0,15 - ;
3. 0,01-0,07 - ;
4. 0,003-0,01 - .
, , R-R-
.

12

LF VLF

, II,

VLF

LF F
VLF ULF

HF

H ,
pO2, pCO2
LF VLF

13

3.
3.1
, :


. . .
:
. .
:




. .
:


:



:
1/f
(CGSA)

.
:


3.2 ,

3.2.1
.
( RR ).
:
. ( , , n, RRNN) RR
. .
, .
,
, .
: 0,940,03 , 0,770,06 .
R-R. ,
.
in R-R. .

14

,
, .
,
.
,
, , . . . . .
, , .
: 0,0060,00086.
( ) . RRNN.
( , , ), .
.
: 6090 1 .
( ) ( RR
, , SDNN, CLV, SDRR) ,
.
.
.
25 : 7010 ; 26-40 : 606 .,
605 ; 40 : 608 , 504 .
As ( ) , .
() () .
V (CV, )
, . /. 100%.
25 : 7,11,1%, 70,4%; 2640 :
5,60,5%, 6,10,4%; 40 : 6,40,7%,
6,10,4%.
,
. , , , .
3.2.2
: (Time Domain).
,
. , , .
:
;
;
.
.
.

15

,
:
RRNN ( , , n, .) RR
. . .
18 : : 94030
, 77060 .
: 76096 .
SDNN ( RR , ,
, CLV, SDRR) ,
.
.
25 : 7010 ; 2640
: 606 , 605 ; 40 : 608 , 504
.
: 14139 .
rMSSD ( RR )
SDNN. .
25 : 49,9315,23 .
: 2712 .
NN50 count , , 50
. , . .
PNN50 , 50 . , , NN50 count.
25 : 29,419,55%.
: 1813%.
,
:
SDNN (SDNNi) NN-, 5- .
: 5415 .
SDANN NN-, 5 . , SDNN.
.
: 127 35 .
SDSD NN-.

(, 1000 10000 ) [139].
, [190].
20-99 [76]

()
20-29
30-39
40-49
50-59
60-69
70-79
80-99

16

( / )
7910
787
787
769
779
729
7310

SDNN
()
15344
14332
13230
12127
12132
12422
10623

SDANNi
()
13743
13033
11641
10627
11131
11420
9524

SDNNi
()
7222
6415
6013
5215
4213
4311
3712

RMSSD
()
4319
3511
3111
259
226
247
16

PNN50
(%)
1813
139
109
66
45
45
33

3.2.3 . .
. . .
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1. 33 .
2. ( ).
3. , .
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II
III
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15
23
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5
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18
39

2
8
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.


600 .
650 .

550 .
575 .

750 .
925 .

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17

.
3.3.1
.
60- .
.
. . [12].
, .
( ) 0,05 ., 0,4 . 1,3 ., 18 . 0,4 1,3 .
, , .
100 . :
h = (Xmax Xmin) / k, :
Xmax ,
Xmin ,
k , k = 1 + 3,322 Ig n.
1/128 (7, 8125 ).
:
1. , , .
2. , ,
. .
3. .
( ).
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, . .
5. . ,
,
. .

18

IV
NYHA


R-R . ,
0,7 ( 85 /) ( ), 0,7-1,0 . ( 85 60 /) (), , 1 ( 60 /)
( ).

19

:
() R-R .
( ).
18 : 0,90,03 ., 0,760,05 .
( , ,
) , , . .

.

.
25 : 353%, 38,51,5%; 26-40 :
473%, 432,1%; 40 : 323%, 432,1%.
( , ) ( R-R ).
. , , .
25 : 0,380,07 ., 0,290,02 .;
26-40 : 0,290,03 ., 0,290,03 .; 40 : 0,280,06
., 0,290,03 .
( )
. ,
. =1/ .
( ) (=/). .
( )
(=/). .
( , -) ,
(=/2 ). :
.
80-150 . .
,
. , (, ) .

20

3.3.2
3.3.2.1
(scatter - ), , , , .
Hoopen M. [160] . . . [33].
.
, R-R ,
, R-R .
:
:
- ; - ; - .
, :
- ; - .
:
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:
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:
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:
- ; - .
:
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:
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( ).
, .
, .

21

:
L (, ) . R-R.
25 : 0,380,07 , 0,290,02 ;
26-40 : 0,290,03 , 0,290,03 ; 40 : 0,280,06
, 0,290,03 .
w (b, ) , .
L/w (/b, ) . , L/w.
S ( ). : S = L w/4.
.
( ) . ,
.
R-R ,
,
.
3.3.2.2
, ,
,
[29].
:
:
- ;
- ;
- .
:
- ;
- ;
- .
:
- ; - .
. .

22


.
R-R
1,7 .

.


.

3.3.2.3

, [29]. , , ,
.
.
, .
, 10-15 ( 750 ).

23

45


10-40%.


10%-40%

:
:
- ; - ; - .
:
- ; - .
:
- ; - .
:
- ; - .
:
- ; - ; - .

, , . , -, , , .

, , [29].
3.3.3

( R-R ).
:
1. , ,
() .
2. ,
, , .
3. ,
, , .

().

24

, . , , , .
( ),
.

, , (
, ,
, ).
() , , , , .


( )

25

3.3.4 . .
,
.
, 7,8125
. , .
. . [74] :
W . ().
WN1 () WN5 () 1% 5% , .
WAM5() WAM10 () 5% 10% .

, () . , . . , , .
, W,
, , .
. . . . , (n=47 ).
(5 ).
,
, .
(W) , .

26


3.3.5
(St. George)
.
7,8125 . (b) : b=2A/h, h
, , . . R-R . .
St. George.


( St. George = 22,8)


( St. George = 18,4)

(HRV)
R-R , 7,8125 ,
. 3715 .
(INN), M. Malik et al. [174-177].
.
, . .
.
:
, , , .
RR-. -

27

RR- [192].
15-20 ( 24 ).
3.4
3.4.1
() R-R . , . . . .

()

(.)

HF
LF
VLF
ULF

0,40-0,15
0,15-0,04
0,04-0,0033
0,0033

2,5-6,7
6,6-25
25-303
303


. .
[51]
[25]
1, 2
1
3, 4
2
5
3
6
4

HF ( , , ) ,
.
LF ( , , ) ( ). ,
() .
VLF ( , , )
- . (, , . .).
ULF ( ) . .

. . 6 () [51].
1. HF. . . , , .
.
2. HF, . . . , . .
3. LF. .
, .
. -
.
4. LF,
(VLF) . . . , .
5. (VLF). . .

28

HF LF.
-.
.
6. (VLF ULF). . - . - ( , . .).
,
. .
.

1 . .

2 . .

3 . .

29

4 . .

5 . .

6 . .

(1 5 . . ),
HF VLF

30

3.4.2

. .
, :

() . . (),
(2/). , .
.
.

.
. .
(HF) , (LF) , , (VLF ULF)
.

31

(
)
.

( 10 )
.

32

:
.
( 5-10%,
, , . .).
, , ,
10%.
, , 10
.
:
( , TF)
. , , , 16000 2 .
- ,
.
: 34461018 2.
HF ( 0,4 0,15 , P)
.
, , .
, , ( ).
: 975203 2.
LF ( 0,15 0,04 , P1) ( ). .
, , ( ).
: 1170416 2.
VLF ( 0,04 0,0033 , P2)
- .
: 765 410 2.
ULF ( 0,0033 0 ) . .
: .
LF/HF ( ) (LF) (HF).
.
.
: 0,7-1,5.
HF% ( , P%)
.
.
, , .
, , ( ).
: 35,7914,74%.
LF% ( , P1%)
( ).
, , .
, , .
: 33,689,04%.
VLF% ( , P2) -
.
, ,
, .

33

, .
: 28,6511,24%.
HF n. u. ( , ) . HF n. u. . : HF n. u. = HF/(TP-VLF) 100%.
, , .
, , ( ).
: 49,49,4%.
LF n. u. ( , ) ( ). : LF n. u. = LF/(TP-VLF)
100%.
, , .
, , .
: 50,69,4%.
( ) . (LF VLF)
(HF).
: 3.
( ) .

. .
3.4.3

. ,
1 .
, .
:
1k ( )
( ). , . ,
, 1k 1.
.
.
25 : 0,430,06; 26-40 : 0,480,05; 40 :
0,60,07.
M0 (0) ,
.
.
.
.
25 : 51; 26-40 : 102; 40 : 177.

34

.
3.5
,
, , . 1/f, , (CGSA). :
, , . D2 , . , , ,
, . [192].
3.6
3.6.1

. ,
. -

35

. . . (), , [12]. 1 10.


:
. ().
. - SDNN
( ).
. : , rMSSD, HF, .
. , ,
(LF).
. -
(VLF).
[8]:
1. , (=1-2).
2. , .
, (=3-4).
3. , , -
- (=4-6).
4. , - , .
(=6-8).
5. () ,
( )
.
(=8-10). (, 1979, , 1991, 1997).
. . : [76-77].
, SDNN, TINN, ( ), . , .
rMSSD, A St. George.
.
3.6.2
(), :

+2

+1

36

,
2

VLF ULF

5 8

LF

1000
1000
2248

-1

-2

2 5

1 2

(
)

HF F
30 50%

HF F
50%

22483366
33664484

4484

,
.
:
+10 +12. .
. .
. .
+7 +9. . - .
. .
.
+4 +6. .
- . , , .
- .
+3 3. . , . .
.
4 6. . . , , . - . -.
7 9. .
, .
10 12. . , . .
3.7
:
, .
, . . , , .
() , .
, ( , . .).
+ .
, 4 :

37

+ +
+

:
() + , , . .
.
() ,
, . . .
() + ,
+ .
()
.
() .
, .
,
II SDNN 50
( )
3 ( ).
, 1000 . 180 SDNN (+ ).
200 (+ ). 150 SDNN (+ , ). 50 (- + ). 180 ,
SDNN, 150 .
30 , SDNN, (+ - ).
770 (- , ).

30

, +
-

150

50

, +
,

, -
, +

770
38

, -
,


:
= 150/(150+50) 100% = 75%
= 770/(770+30) 100% = 96,25%
= 150/180 100% = 83,33%
= 800/820 100% = 97,56%

.

. Wolf .
[199].
G. Casolo . [141].


1

23

R. Kleiger . [167].
. demnuyiwa
. [180].

The Multicenter
Postinfarction Research Group
[195] .

113

T. Gripps .
[156].
X Copie .
[144].
L. Fei .
[152].
T. Facell .
[150].

, %

, %

SDNN<32

84

45

SDNN<50

100

69

SDNN<50

34

88

75

52

HRV<30
ULF<1600 2
VLF<180 2
ULF<1600
VLF<180 2

75
28
30

76
93
92

20

96

HRV<25

87

56

RRNN<700

45

85

SDNN<70

100

87

SDANN<55

88

87

SDNN<50

91,6

77,8

HRV<39

(SDNN<50 , HRV<15 .)
. SDNN 50100 HRV 15
20 . [192]. , SDNN 50 5,3 , SDNN 100
( 4 34% 9% ).
SDNN 50100
(14%)[195].
LF 3,5 pNN50 5,5%
3 [182].
NN50 ( 800) LF ( 35 2), 1
,
[136].
rMSSD 36 , 24
24 ,
( , ) 6 [187].
LF/HF, 2025
, -

39

, , 2 ( 2,7) [183].
,
. ()
, L. Fei . [153]. , ,
[153, 192].
SDNN 1520 . ,
4 SDNN 25 ,
24 , , 40 [130].
,
[82]. 6-8 -
.
. , , .
- :
1. ;
2. (..
SDNN ). (ULF, VLF .)
24 .
3. .

.
(SDNN<50 ) ()
()
(. . ).

, %
40
60
50
75
75
92
11
11

, %
40
50
71
76
86
95
73
80

, %
25
60
5
20
95
92
8
11

, %
43
50
98
97
50
95
80
80

0,6
1,2
2,3
8,0
1,9
17,5
0,4
0.6

3.8

[135, 164, 197].

, 5-6- [164]. (HRV, SDANN).
rMSSD. .

40

. . , ( 5 ,
6 ) [82]. , (HF) 600 2,
(LF VLF) 450 2.
LF VLF 900 400 2
.

. - , - . 15 15 . ,
32 , 2756 0 95
. . R-R
: X, Max,
Min, , D, , , As, Ex, V, , , , , , , , ,
, TP, HF, LF, VLF, LF/HF, HF (%), LF (%), VLF (%), HF n.u., LF n.u, m0,1k, L, w, L/w, S,
RRNN, SDNN, rMSSD, NN50count, PNN50.
21 26 69 c ( II-III , , ). 16 7 44 ,
- ( , ,
). 10 11 33 , , . 47 .
,
5 30 ( 15 21 ), , , .
- , 5 30 ( 15 21
), , .
Microsoft
Excel 2000.
, (, RRNN, R-R Max, R-R Min).
3,6% .
( 69,85% VLF 2,
21,81% LF n.u.). , , , .
,
(). I
1303,54 2 3248,83 2 ( 59,87%
), II 1801,5 2 3194,85 2 ( 43,61%), III
4550,84 2 5820,8 2 ( 21,82%).

41

6000

80
70

5000

60
4000

50
40

3000

30

2000

20

1000

10
0

0
1


(, 2)


(SDNN, )

. , I 244,6 2 1682,2 2 ( 85,45%).


957 2.

80

60

70

50

60
40

50
40

30

30

20

20

10
0

10
0
1

(,%)

(, /)
1
2
3


.
( ).
, , R-R .

,
.
, :
1.
.
2.
( 10-15 ).

42

3. , .
4. , 5
, ,
.
5. .
, , . , ,
, [5].
4.
4.1
-.
:
1. .
2. .
3. , .
4. .
:

, 5 . .
:
.
. , , 4 .
1. .
. 20 . 15- .
2. .
. 1-2 . 30- .
3. - . LF. 1-2
, , 5-10 .
4. -- . (VLF%).

(). 1-2 . ,

.
:
:

43

1. 30:15 ( 30:15) ().


2. .
3. .
1 . 30:15,
R-R, , R-R, .
. K 30:15 1,35.
1,35-1,2 , 1,2 .
:

(R-Rmax - R-Rmin) x 100%


R-Rmax

3
.



30%

44

0-30%
< 0
> 30%,

(=46.1%)

(=33%)

(=12,4%)

(=19,3%)

2 .
(HF LF). .
, .
LF .

= 2480 2

= 1256 2

4 .
. . . 1981 . 10
() . .

1
.

.

.
2
.

.
.
3 .
( ).

.
.
4
(
).
.
.

.
.

. .
.
.




.


.

. .

.

45

5 ( ). . 20-30% .
6 ( ). . 10-20% .
7 ( ). . 10% .
8 .

( ).

.
.
9 .

( ).

. , ( 30%)
.
10 .

( ).

. , ( 30%)
.



.
-
.


.
.


.
.
.

.
.
. .

. .

4.2
.
W. Birkmayer (1976) Z.
Servit (1948) [32].
W. Birkmayer:

, 10 .
.
5 .
1 .
W. Birkmayer:

46

6 :
: 20-40% 5-20 . . . 4- ,
. .
: , .
,
;
. .
:
. - . , ( - ). . .
: .
, ( , ).
: ( , ), 3-6
. ,
.
( , ). .
: , ,
.
.

(.).
(. . .), (/).

47

Z. Servit:
15
, 5 . .
5 .
Z. Servit:

. :
1. .
2. .
3. .
4. .
- . :
1. :
; .
2. :
; .
3. :
; .
4. .
.

48

4.3
. . .
:

10 . .
:
() : ( ) ,
30-90 . .; 30 . .; 90 160 . .; 160 . .
() (/).


< 30
3060
6090
90160
> 160

1,1
1,13
3
1
12,5
2,5
0,9
0,91,8
1,8
0,7
0,71,5
1,5
0,5
0,51,2
1,2

:
1. 48 . ., 92 . .; / = 1,92

2. 124 . ., 280 . .; / = 2,26



4.4
.
.
, Wheeler Watkins
Hilsted Jensen.
:
6 (5 , 5 ) .
4:6 . ,
. .
:

49

0,05-0,15 .
:

.
. . -
. (r-r) 1,4.
1,4-1,2 , 1,2 .
LF/HF [82].
6 , , (LF),
12 1 .
(HF)
0,15-0,25 . LF/HF .
, , . ,
.
,
Hilsted Jensen

:
4.5

50

.
:
.

II [96].
.
(, ).
:
15-20 , 40 . . . .
.
:
4 [96]:
1. ,
. 3- .
2. , , . 6-7 .
3. ,
,
, .
4.
, , . ,
.
:
(K), R-R R-R . K 1,7. 1,7-1,3 , 1,3 .

4.6

, . ( ).
:
. , - ( ), - (), , . . -

51

. , 70-85% ( 70-85%
). . ,
, .
(
).
1,5 , , , .
[67, 89]:
1,5

,

5-9
10-14
15-19

18-22
35
36
33

23-26
33
35
32

27-30
31
33
31

31-35
28
30
30

,
36-40 41-45
26
24
30
29
29
28

46-49
22
27
27

50-53
20
26
27

54-58
18
24
25

59-63
16
23
24


10-15 . 6
5 .
:

() .
:

6-7 .
:
, .
- .
.
( ), . . 25
30 , 25 35 26, 35 45 23,
45 20 . 3
, .
.
:
, , 1,5 10- 1
(). .
1 (). .
:
0 20%
20 30%
30 40%
40 50%

52

. .
,
.
.
.

50%

4.7
.
:
30%
3 .
. .
:
.
:
15 . . . 10-15 . . .
, 10 . . . .
4.8

.
:
, , 1,5 15- 1 (). 0,3 0,1% 0,15 /. , ,
3, 10, 20, 30 40 . 10 1,5 .
: 10 . . ., 10 ,
3 1 .
:
:
1. .
2. .
3. .
, . . .
. .
4.9
- ( -)
.
[32]:
15- 1
(). , 15-25 . 20
() 15 .
:
, .
:
():

= 100 (

) 100

53

3 8.
. 0 3 . .
( -)

.
:
.
.
.
[32]:
15- 1
(). 20
--
. 15 , 15 ().
:
.
:
():

= 100 (

) 100

3 12. 12 16
. 16
. 0 3 . .
( , -)
.
[32]:
15- 1
().
20-30 . 25
() 15 .
:

.
:
. . (1958) W. Birkmayer (1976). .
.
4-12 .
4 .
12 .

54

5.
5.1

[159].
, -
, .
, (T, LF, HF, m0,
), . 4-5 , ( T, LF, HF, m0). . -
(T, LF, m0, ), .
, , 6-8 (.. , ..
, .. , 2001).

1
(Mm)
118,01,7
119,51,7

2
(Mm)
123,92,3
124,72,2


3
4
5
(Mm)
(Mm)
(Mm)
121,62,8
128,83,2
124,83,2
123,32,8
131,23,6
129,43,5

69,86,36

90,628,18

111,615,7

115,415,6

94,29,9

99,311,6

125,93,6

34,43,03
10,61,37
14,40,99
17,11,11
0,510,01
0,510,01

45,873,73
10,991,02
14,81,15
17,11,17
0,490,01
0,480,01

51,675,8
15,322,12
19,51,8
14,51,58
0,490,01
0,490,01

49,45,06
16,32,44
17,62,2
13,41,81
0,470,01
0,460,01

48,74,71
14,51,71
14,21,3
11,41,38
0,480,01
0,480,01

50,74,71
14,31,67
19,01,7
15,41,69
0,450,01
0,450,01

60,77,60
13,62,24
17,32,5
18,73,24
0,460,02
0,450,02

T
(/2)
LF
HF
m0
m0
M

140
120
100
80

6
(Mm)
131,63,2
136,83,5

7
(Mm)
125,23,6
125,23,6


T
LF

60
40
20
0

HF
VLF + ULF
m0
1

55

(1-3 ) , . .
.
(4-6 ) :
. , HF, , .
7-10 , ( )
( , . .) . 7-8 . 9-10-
,
.
11-13 .
( ) 1415 [43].
[20]

(.)
(.)
(%)
(. .)

1-3
0,580,02
0,230,04
282,5
13417,7

4-7
0,620,03
0,230,05
271,0
9415,0

,
8-10
0,720,02
0,280,02
160,9
5711,0

11-13
0,730,02
0,270,02
231,5
8210,0

14-15
0,740,02
0,340,04
181,0
396,6

0-2 [76]

0-1 .
2-3 .
4-5 .
6-9 .
4 . 2

3-5

6-8

9-11

12-15

Xc. ()
39411
44926
45916
46122
47959
546,341,3
618,335,6
703,228,4
668,242,4
793,934,5
676,646,8
823,554,5
740,252,1

SDNN ()
485
648
6512
6513
7021
116,613,1
123,714,5
131,810,2
140,714,2
183,419,2
163,518,9
227,356,6
183,621,4

rMSSD ()
225
265
278
224

50,26,6
47,65,6
54,27,8
54,87,3
72,69,3
63,99,2
82,512,3
77,17,8

PNN50 (%)
0,980,3
2,62,1
2,72,4
1,71,6

13,45,3
15,14,3
21,34,2
19,73,8
33,48,5
24,48,6
42,76,8
39,96,8

,
. ,
, .
.
,
, .

56

5.2
5.2.1
( ) , .
, , , . : I , (
T ST I, II, V5, V6), , . . . .
, ,
( 14-20%, 0,71,1, 0,24-0,48 , HF%). - . , , ,
2/1,
. - .
, .
(0,5-0,62 ), (0,08-0,12 ), (38-52%) (120-400 . .).
- . . , 1/3
- . ,
.
-- . .
, . , ,
, (, , .). , .
,
( , , , ), , ,
B6, - ().
WPW, I ,
( ), ,
(, , ).
, .
.
5.2.2
, , , , , .
.

57

(, ) , .
0,66-1,10 , 14-24%, 0,23-0,54 , 40 .
.
(2/1 3). ( 80 . .)
(2/1 0,7). ,
, .
,
. , . . ,
, . ,
.
, , . , ( . .), , , .
5.2.3
. .
,
: SDNN rMSSD
: (T), LF HF. (LF/HF) . , ( ) , .
. ,
.

.
, , , , , rMSSD, SDNN
.
(HF) , ,
. LF/HF
. ,
. .

: , ( . ., . ., . .)

58

,
, . .
HF, 2
SDNN,
rMSSD,

0,410,02
41,132,59
3585435
0,0920,004
0,1030,006

0,360,01
49,991,64
1789154
0,0740,002
0,0760,003

0,4020,013
41,0542,393
2740371
0,0900,004
0,1070,007

ANOVA
<0,01
p>0,05
<0,01
<0,001
<0,001

, LF .

( ) , . .
(, SDNN, rMSSD) , .
:
( . ., . ., . .)
.,
., . .
Am ., %
LF ., 2
SDNN .,
RMSSD .,


0,1490,010
421,661,4
59,93,9
1357216
0,0310,002
0,0220,002

0,2270,019
218,534,9
46,72,8
1575117
0,0480,004
0,0340,005

ANOVA
p<0,01
p<0,01
p<0,05
p<0,05
p<0,01
p<0,05


, . , :
, : SDNN ,
.
.
:
( . ., . ., . .)
.,
., . .
A ., %
SDNN .,


0,1310,015
767,6124,9
68,94,2
0,0290,003

0,1600,010
377,743,5
55,82,8
0,0340,002

ANOVA
P<0,05
P<0,05
P<0,01
P<0,05

, .
. .
.

5.2.4

59


( , , ) : , ( 34%) ( 200
. .). , ( . . ). , , , .
, ( ).

:

, %

, . .

0,67-0,50
0,58-0,46
0,49-0,38
0,40-0,32

0,40-0,14
0,12-0,08
0,06-0,04
0,02

17-34
35-45
46-75
76-98

48-199
200-749
750-2999
3000-6805

,
.

. (
. . ).
.
. , .
,
, , , , .
5.2.5 -
, , , , -
. .
-
( 30 . .). , , (
. 90 . .). .
, , ,

( 100 200 . .)
, - . ( 100300 . .) ,

( 30 . .) .

60

.
, (, , , , ,
, .),
.
, , ,
, , , .
6.
6.1
6.1.1
.

, . ( ).
:
, ;
;
;
;
.
:
(),
(HF);
1 . . ;
,
(SDNN , , . .);
30:15.

, . , LF VLF
30:15 .
, 15 .

1,5

61

1
, .
6.1.2
. .
() :
1. 10-20%, HF
LF. .
2. 20% . (HF) (LF) , .
3. 10%,
HF LF. .
4. HF LF (
), . .
. (
).

: . , .
, , .
, . , .

62

50
45
40
35

30

25

20

15
10
5
0

6.1.3

, .
. . :
;
(LF% VLF%)
(HF%);
.

63

, . , , . , , .
6.2
6.2.1
() . , , [96]:
( 40 );
( 5 );
: ( 75% 83% ),
;
:
;
-: , ;
- :
;
: ,
. .
.
. ,
.
.

. - ,
. . , ,
.
, ,
. , , (. ).

[82].
1 , , .

64

2 . - .
3 ( VLF 60%).
400 2, .

( .)

, /
SDNN,
rMSSD,
PNN50, %

(n=9)
73,94,2
59,85,3
42,46,1
21,15,1

(n=25)
74,92,8
38,14,1
25,23,3
7,62,7

. ,
() 400 2, (SDNN) 20 , (LF/HF) 2,5,
(VLF%) -
-.
[81, 107].
.
,
. .

, %

VLF

,
/
60

( -
-II).
60-70
( -
-II). ().
70 ( -
-II). ().
70 - LF
. , , ,
, .
60-70
-.
50-60
. - .
.
50 .
- . .
60 ().
F
60 ().
, , , .

65

, .
6.2.2
, . ,
. 0,5%,
7-17%.
, , ( ). , , .
.
, , . .
, ,
.
.
:
;
(VLF VLF%)
;
(HF HF%);
(LF%).
, ,
, ,
.
6.2.3
.
.
, . , [22]. 1-3 77,4-81,3% 10%.
4 .
75,4%
: HF 18,5%, LF 21,5%, HF LF 35,4%
( 75,4%, 40,5%). [21]. (SDNN, rMSSD, NN50, 2, HF 2 ..).
. ,
SDNN 70
8,8 [82].
,
[22]

66


, .
1
2
3
4


HF,
LF, 2

2
0,04
0,06
0,20***
0,07
0,04
0,17**
0,13*
0,14*
0,21***
*
**
0,12
0,18
0,22***

0,14**
0,15**
0,09
0,16
*
**
0,13
0,15
0,10
0,12*
0,12*
0,13
0,10
0,10
0,11
0,12*
0,12
0,10

: . : * <0,05; ** <0,01; *** <0,001.



:
, (, , );
;
;
.
. . (
).

,
> 400 2, SDNN > 20-25

( )

< 400 2, SDNN < 20-25


,
HF, LF, VLF,

120 1 , ST 2 ;
ST 6 ; ST ;
ST Q;
;


HF, LF, VLF,
. ( , LF%) -. (
,
HF%) . . - (
,
LF%), , , -II.
6.2.4

67


.
: ,
. - . . Q , Q [167]. ,
[169].
.
, . , - - .

.
. ,
.
:
( ) ;
;
;
;
.
( ,
. .). . (SDNN , HRV .) (VLF 2, HF 2). , SDNN 15-20 . RRNN.
,
(SDNN) 50 (HRV) 15 . ( ).

: , ,
.
.
, .
. . [123]
().
= 5 ln(RRNN)-1,7 x -1,3 ln()-0,5 ln(VLF)
RRNN RR ( ),
( 0 , ),
- , VLF 2.
25,8 . 1,5%;
25,1-25,8 8,8% , 25,1 42,4%.
:

, . -

68

3-10 [26]. :
;
(TP 2), , (HF 2) ;
(LF% VLF%)
, .
3 , HF , . , , [135, 171, 172]. , ( ) .
, ()
() Bigger at al.

SDNN,
SDANNi,
SDNNi,
rMSSD,
PNN50, %
TP, 2
ULF, 2
VLF, 2
LF, 2
HF, 2
LF/HF

(n=274)
14138
12735
5415
2712
97
2122211663
1842010639
1782965
791563
229282
4,612,33

(n=278)
11240
9938
4618
2815
1011
143030353
121309241
14601090
511538
231324
3,602,43

(n=684)
8130
7027
3516
2312
79
73235720
60674861
850800
277335
129203
2,752,13

, -, 3
2-4
[124]. , 2-4 , 67 ,
.

RRNN
SDNN
SDNN / RRNN
100%
ln (TP, 2)
ln (VLF, 2)
ln (LF, 2)
ln (HF, 2)
LF / HF
LF, nu

2-4-
> 67
67
806,1
1051,5
18,0
34,0
2,2
3,2
5,8
5,0
4,4
4,3
1,3
53,9

7,2
6,3
5,9
5,8
1,1
52,4

3-
> 67
67
907,8
1071,0
33,0
38,0
3,5
3,5
6,8
5,9
5,4
5,3
1,3
53,3

7,3
6,3
6,1
5,9
1,2
54,4

1
> 67
67
896,9
969,7
28
36
3,4
3,6
6,9
6,2
5,7
5,2
1,6
61,4

7,2
6,4
5,9
5,5
1,3
58,2

, , .
, ( ).
6.2.5

69

():
( ,
);
;

;
;
.
.
, . , (LF%) (VLF%) . , .
: -II , . ,
, ().
. (TP 2) (HF 2)
(LF 2) . , (LF) .
[165].
(VLF 2) .
, .
SDNN SDANN 70 55 ,
6 ( 100% 88%
, 87% ) [152].
. . . , . ,

NYHA [95, 96].
6.2.6
, ,
. . , (LF) (RRNN). , . .
(1997) (TP) .
6.2.7
. , [155, 188]. (HF) (LF) . - (VLF).

70

:
( LF), ,
, ( HF) [151].
(HF LF)
.
,
. -, .
6.2.8
:
(
), ();
- ;
.
,
.
5 50%.
:
:
(HF 2);
(LF 2) [132, 181];
( 2)
(LF) (HF) LF/HF;
;
;
.
:
LF- ;
30/15 ( 30/15) 1,2 ;
(r-r) 1,1 .

[32]:
;
( );
;
;
;
;
;
;
;
( );
.
, . .
56 II 18 73 .
8 I-II . .

71


, /
SDNN
rMSSD
HF2
LF 2
, . .


(n=48)
73,41,4
22,01,4
13,71,1
577
12022
54579


(n=8)
80,62,3
16,72,0
7,71,1
286
5516
745227

II , .
, II , .
, ,
. () (SDNN).
, .
6.2.9
[110].
. ,
(220 , 95 86 )
:
( )
LF HF. VLF
.
- , , ,
VLF ( )
(HF% LF%). ,
(VLF) .
, , VLF,
. VLF
( 5 ) (4- 2,5 ), , VLF-.
- , , (TP
2) ,
. : LF VLF,
HF VLF.
.
: LF , , - ,
VLF - .
.

72

, , VLF, .

LF ( ) .
.
[101]:
, 0,1 0,25 ( HF LF), . , . ( -)
.
, .
, , .
-
.
(HF 2). , -,
, - .
,
.
6.2.10

(). ,
.
[12]:
1. .
2. , .
3. .
: , ,
.
[12].
, , .

( ) ,
, . , [99].

73

(./.)
75,42,4
103,52,8

(.)

(%)

SDNN ()

322,1
351,8

(. .)
17810,2
36424,1

0,780,02
0,580,01

109,62,6
120,63,1
90,21,2

0,550,01
0,50,008
0,680,01

39,32,04
51,22,6
44,82,1

57629,3
93535,7
48721,4

16,80,8
10,70,2
18,31,02

110,11,4

0,550,01

48,21,8

62020,5

16,80,8

73,61,04

0,80,02

26,41,2

164,712,1

23,11,04

24,11,6
19,11,1

, (. . . . ).
6.2.11
-:
;
( (LF 2) 50%,
LF-) [192];
(
(HF%) 145%,
(LF/HF), ) [62];
;
- 60 [54];
(, .);
-
[81].
2+ (,
.):
;
( (LF));
( (HF), (LF/HF),
).
:
1 ;
3 (, .) : , ;
( (HF) ).
-II:
;
- (
(VLF));

74

(
(HF%), ) [61];
(VLF%) [81, 107].
:
;
(
(HF%), ).
- (, , ):
;
( (LF));
( (HF),
(LF/HF), ) [61].
-:
;
( (HF), (LF/HF),
);
( (LF%));
.
, :
(,
) ;
(, ) ;
(, ) ;
() .
.
. [192]:
;
( (HF),
).
:
[62].
7.

()
(R. Kleiger ., 1987):

, . . ,
, .
, . , 30/15 .
,
,
-

75

. , / .
.
, .
, .
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.
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.
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.

. . . El-Bedawi . (1994), , R-R ( ).
.
, ,
, .
7.1

, . :
I, II, aVF, V2-V6 ;
-Q -R;
( R-R).
, . .
, ( , HF). , , . .
[74] . .

.
.

40 100 1 . 60 90 , 50 60 , 40 50 ,
40 . 90-100 / , 100 .
.
, . .
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76

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.
, (SDNN) 25
.
:
( 80 1 ).
( 80 1 ).

, (, , III-IV NYHA).
, ,
,
.

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12- ).
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77

,
. , , ,
.
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.
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:
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:
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:
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:
;
():
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78

:
- ( );
- ;
- .

(Lawn-Wolff, 1971):

0
1
2
3
4
4
5


1-30 1
30 1
()

3 ( )
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, .
, , , . ( ),
.

79


. ,
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( ) () R-R .
. , ,
R-R, , , .
. , .
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1
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().
, (1:1 ; 2:1 ; 3:1 . .).

, RR .

80


, , .
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81


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82


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83

1
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:
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;
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).
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:
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84

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, , , . . ( ).
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);
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. (). .
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., 4

85


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86


[73]:





[57, 58]



-
-
-
-
- ,
- ()
- (HF)
- (100-150
/)
- (50-75
/)
-
-

,
- (LF
VLF)
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2
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/)

. ,
.
7.5
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, . , , , .
, . .
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87

, .

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(LF) .
8.

, , :
;
;
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:
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. .);
;
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8.1
. , -

88

. , 60 R-R
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R-R . ,
.
( ). 5 . .

., 5

., 10

., 2,5
, , 5-10% ,
.

89


(. 3.4.1. ).
, R-R .


8.2
, , Max (), Min (), , V (%).
60 90 1 . Max () Min () . (, ),
, .
X (), R-R , .
,
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40 (0,040 ).

90

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, ,
.
SDNN () () RRNN () X ()
.
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SDNN ().
NN50count PNN50 (%)
, 50 . PNN50 (%)
10-15%.
rMSSD ()
pNN50 (%) NN50count, .
8.4
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1%. 50%
.
/2 . , - . ()
.
,
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435. .

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91

(%) = 15; () = 0,67

(%) = 10,3; () = 0,669

8.5
.
0,4 1,4 . . .

0,4-1,4 .

0,7-1,1 .

8.6
.
1k , M0. M0 , .
.
M0 25 : 51; 26-40 : 102; 40 : 177.
8.7
, : (2), HF (%), LF
(%), VLF (%), LF/HF .
,
.

92

(2) , . .
, , 2
( ) :

., 20

93

HF (2) HF (%) . .
LF (2) LF (%) . VLF (2) VLF (%) - . VLF (%) .
,
.
. , HF (%) (2) .

, , HF (%)

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94

8.8
.
, . , , (, , W . .) :

W,
.


. .
.
1

: 03.05.2002

: 17
:
. 4.9 (291 .). QRS : 282.

X ()

1.034

Max ()

1.140

Min ()
. ()
D
(/)

0.891
0.006
0.0025
59.0


()
(%)
()

1.050
33.3

0.627

0.360
2

TP ( )

2457.7
2

0.250

HF (P) ( )

3.813

63.543

1510.2

LF (P1) ( )

404.1
2

VLF (P2) ( )

543.4

95

()

0.050

As

-0.248

Ex

-0.412

V (%)

4.9


RRNN ()

1034.3

SDNN ()

50.4

133.440

31.746


()

ULF (2)

0.0

LF/HF

0.3

HF (%)

61.4

LF (%)

16.4

L (c)

0.284

VLF (%)

22.1

w (c)

0.191

ULF (%)

0.0

L/w

1.488

HF n.u. (%)

78.9
21.1

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55.9

S ( )

0.043

LF n.u. (%)

NN50count

121

()

1.539

PNN50 (%)

42.9

HRV ()

13.4


m(RRM) ()


m0

1k

0.622

m()
m() (%)

1.034
1544.2
0.0

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195.3

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7.8

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210.9

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195.3

96


1. .
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(++)

97


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:
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0 .

: _____________________

98

: 03.05.2002

: 17

30/15

1.449

1.35

(%)

31.0

30 %

(/)

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7 18


(c)

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80.0

80.0

0.0025

0.0039

0.0016

X ()

1.034

0.756

0.750

Max ()

1.140

0.896

0.872

Min ()

0.891

0.619

0.672

0.0025

0.0039

0.0016

0.050

0.063

0.040

4.9

8.3

5.4

. ()
()
V (%)


()

1.050

0.750

0.700

AMo (%)

33.3

37.3

53.7

()

0.250

0.278

0.200

3.813

4.804

7.158

63.543

89.485

192.173

133.440

134.228

269.042

0.627

13.740

10.935

0.360

11.746

7.597

2457.7

3869.3

1615.9

1510.2

262.5

135.4

TP ( )
HF ( )
2

LF ( )

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523.3

451.9

543.4

3083.4

1028.6

0.0

0.0

0.0

LF/HF

0.268

1.994

3.337

HF (%)

61.4

6.8

8.4

LF (%)

16.4

13.5

28.0

VLF (%)

22.1

79.7

63.7

ULF (%)

0.0

0.0

0.0

HF n.u. (%)

78.9

33.4

23.1

LF n.u. (%)

21.1

66.6

76.9

VLF ( )
ULF ( )

99


m0

1k

0.622

0.083

0.113

()
L (c)

0.284

0.346

0.275

w (c)

0.191

0.121

0.084

L_W

1.488

2.869

3.251

S (c )

0.043

0.033

0.018

()

1.539

2.170

2.439


RRNN ()

1034.3

756.3

750.1

SDNN ()

50.4

62.8

40.4

rMSSD ()

55.9

22.1

19.0

NN50count

121

PNN50 (%)

42.9

2.9

1.0



. .

4 - ( ). .

.

.
, .
.

.


. 3
.

: . . - .
: _____________________

100

: 16.04.2002

: 28

Krr

2.492

1.062

0.975

0.615

0.811

3326.2

23255.1

1373.9

11775.1

TP ( )
HF ( )
2

LF ( )

615.3

1928.9

844.5

9551.0

ULF ( )

492.6

0.0

LF/HF

0.448

0.164

HF (%)

41.3

50.6

LF (%)

18.5

8.3

VLF (%)

25.4

41.1

ULF (%)

14.8

0.0

HF n.u. (%)

69.1

85.9

LF n.u. (%)

30.9

14.1

VLF ( )



:

:
:

: _____________________

101

: 10.02.2002

: 37


1.533


:
:

: _____________________

,
[192]

102

Guzetti, 1991,
40 ,
30
Langewiz, 1994
41 ,
34 ,
54
Saul, 1988
25 III-IV .
NYHA,
21

LF
. LF.
.
, ().
, LF HF
. , .

Casolo, 1989 [140]


20 II-IV .
NYHA,
20
Binkley, 1991
10
14-40%,
20
Kienzle, 1992 [165]
23 II-IV .
NYHA
Townend, 1992
12 III-IV .
NYHA
Binkley, 1993
13 II-III .
NYHA

Woo, 1994
21 III .
NYHA

Axelopoulos, 1988
19 ,
10


(>0.01 ) /.
.


(24-48 .)


(24 )


,
(24 )

(24 )

Sands, 1989 [188]


17 ,
6

Stein,1993
38


(24 )

Marangoni, 1993
39 ,
24

Counhilan, 1993
104

(24 )

Dougherty, 1992
16
, 5
,
5
Huikuri, 1992
22
,
22
Algra, 1993 [130]
193 ,
230


(24 )

12 HF.

.
.

: .
0,02 1,0 90%.
.
, ULF 2 SDANN
( ,
. .).
HF.

LF SDNN 1 .

1


(24 )

HF .
LF


(24 )

(0,05-0,50
)
2,6 ,
(0,02-0,5 ) - 2

103

Myers, 1986
12
(6 ),
6
Martin, 1988
5
,
20
Vybrial, 1993
24 ,
19


(24 )

.
HF (0,35-0,5 )


(24 )

SDNN .


(24 )

Huikuri, 1992
18


(24 )

Holnloser, 1994
14
,
14


(24 )

Kocovic, 1993
64


(24 )


,
. .

. . ,
,
/
, .

: ; ,
; ; ;
; ; ; ; .

104


1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.

. ., . ., . ., . ., . ., . ., . .
. 1997; 12:26-29.
. . . .: , 1975, 448 .
. ., . ., . . . 1995; 12:8393.
. . . . ., 1979, 18 .
. . . , 2000, 424 .
. ., . ( ). 1995; 3:41-50.
. ., . ., . ., . . . 1989; 2:11-15.
. ., . . .
.: , 1997, 265 .
. ., . ., . . , . . . .: , 1968, 51-61.
. ., . . : . 2001; 3:108-127.
. . . .: . .: , 1976, 161-175.
. ., . ., . .
. .: , 1984, 220 .
. ., . . . . ., 1986, 142 .
. ., . . . .:
. , 1968, I:751.
. . . .: , 1979, 295 .
. ., . . . 1978; 18(4):44-50.
. . . .: . .: , 1968.
. .
. . .
. . ., 1996, 219 .
. . . 1996; 1:4-11.
. ., . . . ., 1987, 448 .
. . .
2001; 4:57.
. ., . .
. 2002; 1:48-51.
. . .
1981; 5:94-96.
. ., . .
. 1997; 7:29-32.
. ., . . . .-.: , 1997.
. ., . ., . . - . . 1994; 7-8:106-109.
. . . . . . . .: , 2000, 135 .
. ., . . . .
. . . 1987; 10:409-411.
. ., . .
. 1999; 6:54-59.
. ., . ., . ., . ., . ., . .
, Q-T
. 2002; 1:70-75.
. ., . ., . ., . . . . , 1997.
. . . , , . .:
, 2000, 752 .

105

33. . ., . ., . . .
R-R. , . , 1971, 9-14.

34. . ., . .
. .: , 1974, 221 .

35. . ., . ., . . . .
. , 1998.

36. . . . .-.: , 2001, 480 .


37. . ., . . :
. 1983; 11:5-9.

38. 17562-72. . . 39.


40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.

( 1985 .) 1,2, 1983 ., 1984 . .N 4025


28.11.84 ( 7-83;2-85)
24878-81. ( 2483-80) . .
25780-83. ( 3652-82) . .
25995-83. ( 3932-82) .
.
.. . .
. V 24-27 1978 . .: , 1978, 199-200.
.., .., .. . 2001;
1:15-18.
., ., . . .: , 2000, 208 .
. . . .: , 1993.
. ., . ., . ., . .
. .: .
VII 12-14 1983 . .: , 1983, 35-36.
. . . 1992; 32(3):50-52.
. ., . ., . ., . .
. 1988; 28(4):35-41.
. ., ., ., . . . - . 1998; 24(6):56-66.
. . . .
, 1980.
. . : .
. . . . , 1972, 285 .
. ., ., . . . .: . : , 1982, 5-22.
. . . .-.: , 1995.
. . . - .
1998; 6:30-36.
. ., . ., . . : -
. 1998; 2:9-15.
. ., . ., . ., . ., . ., . .
, . 1998; 12:64-73.
. ., . ., . . .
1997; 3:42-46.
. .
- : . 1998; 9:20-26.
. . , , 1985.
. . . ., 2000, 387 .
. ., . ., . . : ,
, . 2000; 2:56-62.
. . (
). . . . .: . . , 1981, 298 c.
. ., . . . 1992; 18(4):91-95.
. . . ., 1989, 400 .

106

65. . ., . ., . . 66.
67.
68.
69.
70.
71.
72.
73.
74.
75.
76.
77.
78.
79.
80.
81.
82.
83.
84.
85.
86.
87.
88.
89.
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.

. 1980;
6:100-102.
. ., . ., . . ,

. 2001; 12:39-43.
. . . .: , 1983, 367 .
. ., . ., . ., . . -,
. 1987; 27(3):40-45.
. ., . .
. 1995; 6:146-152.
. ., . ., . ., . . . 1999; 25(1):7886.
. ., . ., .
. 1978; 4:734-742.
. ., . . . 1995; 6:160-165.
. . . . 2-. .-.: , 1998.
. ., . ., . .
. 1995; 1:45-50.
. . . ., 1987, 115 .
. . . .: , 2000, 216 .
. . . 1998; 24(2):56-62.
. ., . ., . ., . .
. 2001; 11:66-69.
. ., . ., . ., . .
. 1993; 33(2):31-33.
. ., . ., . ., . . :
. 1999; 12:11-13.
. ., . . (
). , 1998, 162 .
. . . . , 2000, 200 .
. . .
. , 1983.
. ., . . . .: , 2000, 312 .
. ., . ., . ., . ., . . . 1995; 67(9):66-69.
. ., . . .
1993; 19(3):80-87.
. ., . ., . ., . .
Q-T R-R . 2002; 2:76-83.
. . . .: , 1983, 296 .
. . . .: , 1997.
. ., . ., . ., . . . .: , 1967, 206
.
. . . . 1996; 4:43-44.
. ., . ., . . , . 1998; 2:15-19.
. ., . . - . .: , 1968, 131 .

.
http://infoart.apex.dp.ua/med/cons/texts/hrv.htm, 05.10.1997.
. ., . . . 1996; 10:87-97.
. ., . . . .: , 2000, 200 .
. ., . ., . . . 1997; 8:82-94.
. .
. 1997; 8:24-28.
. ., . . .
. . . ,
1999; 187-188.

107

100. . . , .
1999; 2:70-74.

101. .., .., .., .., .. . . . . , 1999.


102. . ., . . . .: , 1975, 224.
103. . . .
1997; 10:21-24.
104. . ., . ., . ., . ., . .
. . , . , 1993, 260-261.
105. . . . ., 1975, 302 .
106. . ., . . . 1988; 7:3739.
107. . . . : , 1998.
108. . .
. . . . . .: , 1996, 236 .
109. . ., . ., . . . 1989; 9:25-28.
110. . ., . . . . . . , 1999; 131-133.
111. . ., . ., . ., . .

. 1998; 1:22-30.
112. . ., . ., . ., . .
, . 1997; 7:4-14.
113. . ., . ., . . . . . 1999; 127:620-624.
114. . ., . ., . ., . .
c . 2001; 5:38-45.
115. . . .: , 1997.
116. . . : - . .: ,
1992.
117. . . . .: , 1997.
118. . . . : , 1988, 196 .
119. . ., . ., . . .: , 1992, 368
.
120. . ., . . . 2001; 7:50-53.
121. . ., . ., . . : ( 1). 1997; 2:61-67.
122. . ., . ., . . : ( 2). 1997; 3:74-81.
123. . ., . ., . ., . . ,
. 1999; 6:6-15.
124. . ., . ., . . , , . 1999; 5:4-12.
125. . ., . ., . . , ,
. 2001; 8:4-10.
126. . ., . ., . ., . . .
., 1984, 288 .
127. ACA/AHA Guidelines for Ambulatory Electrocardiogrphy. A Report of the American College of Cardiology/ American Heart Assotiation Task Forse on Practice Fuidelines. Am J Cardiol 1999; 34:912-948.
128. Akselrod S. Components of heart rate variability. Basic studies. In: Heart rate variability. Eds. M. Malik. A. J. Camm.
Armonk-New York: Futura Publishing Company Inc 1995, 147-163.
129. Akselrod S., Gordon D., Ubel F. A., Shannon D. C., Barger A. C., Cohen R. J. Power spectrum analysis of heart rate
fluctuations: a quantitative probe of beat to beat cardiovascular control. Science 1981; 213:220-222.
130. Algra A., Tijssen J. G., Roelandt J. R. et al. Heart rate variability from 24-hour electrocardiography and the 20 yers
risk for sudden death. Ibid 1993; 88:180-185.
131. Berger R. D., Akselrod S., Gordon D., Cohen R. J. An efficient algorithm for spectral analysis of heart rate variability.
IEEE Trans Biomed Eng 1986; 33:900-904.
132. Bernardi L., Ricordi L., Lazzari P. et al. Impaired circulation modulation of sympathovagal modulation of sympathovagal activity in diabetes. Circulation 1992; 86:1443-1452.

108

133. Berntson G. G., Bigger J. T., Eckberg D. L. et al. Heart rate variability: origins, methods and interpretative caveats.
Psychophysiology 1997; 34:623-648.

134. Bigger J. T., Steinman R. C., Rolnitzky L. M., Fleiss J. L., Albrecht P., Cohen R. J. Power Law Behavior of RRInterval Variability in Healthy Middle-Aged Persons, Persons With Recent Acute Myocardial Infarction and Patients
With Heart Transplants. Circulation 1996; 93:2142-2151.
135. Bigger J. ., Fleiss J. L., Rolnitzsky L. ., Steinman R. . Stability over time of heart period variability in patients
with previous myocardial infarction and ventricular arrhythmias. Am J Cardiol 1992; 69:718-723.
136. Bigger J. T., Fleiss J.L., Rolnitzky L.M., Steinman R.C. The ability of several short-term measures of RR variability to
predict mortality after myocardial infarction. Am J Cardiol 1993; 88:927.
137. Bigger J. ., Fleiss J. L., Steinman R. . et al. RR variability in healthy, middle-age persons compared with patients
with chronic coronary heart disease or recent acute myocardial infarction. Circulation 1995; 91:1936-1943.
138. Bigger J. ., Rolnitzsky L. ., Steinman R. . Prediction mortality after myocardial infarction from the response of
RR variability to antiarrhythmic drug therapy. Am J Cardiol 1994; 23:733-740.
139. Bjokander I., Held C., Forslund L. et al. Heart rate variability in patients with stable angina pectoris. Eur Heart J 1992;
13:379.
140. Casolo G., Balli E., Taddei T. Decreased spontaneous heart rate variability on congestive heart failure. Am J Cardiol
1989; 64:1162-1167.
141. Casolo G.C., Stroder P., Signorini C. et al. Heart rate variability during the acute phase of myocardial infarction. Circulation 1992; 85:2073-2079.
142. Cavalcanti S., Severi S., Chiari L., Avanzolini G., Enzmann G., Bianco G., Panzetta G. Autonomic nervous function
during haemodialysis assessed by spectral analysis of heart-rate variability. Clin. Sci. Colch. 1997; 92(4):351-359.
143. Cohen H., Matar M. A., Kaplan Z., Kotler M. Power spectral analysis of heart rate variability in psychiatry. Psychother-Psychosom. 1999; 68(2):59-66.
144. Copie X., Hnatkova K., Staunton A. et al. Predictive power of increased heart rate versus depressed left ventricular
ejection fraction and heart rate variability for risk stratification after myocardial infarction. Am J Cardiol 1996; 27:270276.
145. Christ M., Seyffart K., Wehling M. Attenuation of heart rate variability in postmenopausal women on progestincontaining hormone replacement therapy [letter]. Lancet 1999; Jun 5; 353(9168):1939-1940.

146. Dekker J. M., Schouten E. G., Klottwijk P. et al. Heart rate variability from short electrocardiographic recordings predicts mortality from all causes in middle-aged and elderly men. The Zutphen Study. Am J Epidemiol. 1997; 145:899-908.

147. Eckberg D. L. Sympathovagal balance. A critical appraisal. Circulation 1997; 96:3324-3332.


148. Ewing D. J., Martin C. N., Young R. J., Clarke B. F. The value of cardiovascular autonomic function tests: 10 years
experience in diabetes. Diabetic Care 1985; 8:491-498.

149. Ewing D. J. Noninvasive evaluation of heart rate: The time domain. Clinical autonomic disorders. Ed. P. A. Low.-Boston
etc.: Little Brown and Co., 1993; 297-315.

150. Facell T.G., Bashir Y., Cripps T. et al. Risk stratification for arhythmic events in postinfarction patients based on heart
rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram. Ibid 1991; 18:687697.

151. Fallen E. L., Kamath M. V., Ghista D. N., Fitchett D. Spectral analysis of heart rate variability following human heart
transplantation: evidence for functional reinnervation. J Auton Nerv Syst 1988; 23:199-206.

152. Fei L., Keeling P. J., Gill J. S. at al. Heart variability and its relation of ventricular arrhythmias in congestive heart failure. Br Heart J 1994; 71:322-328.

153. Fei L., Malik M. Short- and long-term components assessment heart rate variability for postinfarction risk stratification.
Eds. M. Malik, A. Camm. Armonk: Futura 1995:341-346.

154. Fioranelli M., Piccoli M., Mileto G. M., Sgreccia F., Azzolini P., Risa M. P., Francardelli R. L., Venturini E., Puglisi A. Analysis of heart rate variability five minutes before the onset of paroxysmal atrial fibrillation. Pacing-ClinElectrophysiol. 1999; 22(5):743-749.
155. Freeman R., Saul J. ., Roberts M. S. et al. Spectral analysis of heart rate in diabetic neuropathy. Arch Neurol 1991;
48:185-190.
156. Gripps T. R., Malik M., Forelli T. G. et al. Prognostic value of reduced heart rate variability after myocardial infarction: clinical evaluation of a new analysis method. Br Heart J 1991; 65:14-19.
157. Guzzetti S., Dassi S., Pecis M. et al. Altered pattern of circardian neural control of heart period in mild hypertension. J
Hypertens 1991; 9:831-838.
158. Hojgaard M. V., Holstein-Rathlou N. H., Anger E., Kanters I. A. Dynamics of spectral components of heart rate variability during changes in autonomic balance. Am J Physiol 1998; 275:H213-219.
159. Hon E. H., Lee S. T. Electronic evaluation of the fetal heart rate. Am J of Obstet Gynecol 1965; 87(6):814-826.
160. Hoopen M., Bongearis J. The scatergram. J Cardiovasc Res 1969; 3:218-226.
161. Kamada T., Sato N., Miyake S., Kumashiro M., Monou H. Power spectral analysis of heart rate variability in Type As
during solo and competitive mental arithmetic task. J Psychosom Res 1992; 36(6):543-551.
162. Kamath M. V., Fallen E. L. Power spectral analysis of heart rate variability: a noninvasive signature of cardiac autonomic function. Crit Rev Biomed Eng 1993; 21(3):245-311.
163. Kamath M. V., Fallen E. L. Correction of the heart rate variability signal for ectopics and missing beats. In: Malik M,
Camm AJ, eds. Heart rate variability. Armonk: Futura 1995:75-85.

109

164. Kautzner J. Reproducibility of heart rate variability measurement. In: Malik M., Camm A. J. eds. Heart rate variability.
Armonk: Futura 1995:165-171.

165. Kienzle M.G., Ferguson D.W., Birkett C.L., Myers G.A., Berg W.J., Mariano D.J. Clinical hemodynamic and sympathetic neural correlates of heart rate variability in congestive heart failure. Am J Cardiol 1992; 69:482-485.

166. Kleiger R. E., Bigger J. T., Bosner M. S. et al. Stability over time of variables measuring heart rate variability in normal subjects. Am J Cardiol 1991; 68:626-630.

167. Kleiger R. E., Miller J. P., Bigger J. T., Moss A. J. and the Multicenter Post-infarction Research Group. Decreased
heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol 1987;
59:256-262.
168. Kontopoulos A. G., Athyros V. G., Didangelos T. P., Papageorgiou A. A., Avramidis M. J., Mayroudi M. C.,
Karamitsos D. T. Effect of chronic quinapril administration on heart rate variability in patients with diabetic autonomic
neuropathy. Diabetes-Care 1997; 20(3):355-361.
169. Kuo C. D., Chen G. Y. Comparison of three recumbent positions on vagal and sympathetic modulation using spectral
heart rate variability in patients with coronary artery disease. Am J Cardiol 1998; 81(4):392-396.
170. Laitinen T., Vauhkonen I. K., Niskanen L. K., Hartikainen J. E., Lansimies E. A., Uusitupa M. I., Laakso M.
Power spectral analysis of heart rate variability during hyperinsulinemia in nondiabetic offspring of type 2 diabetic patients: evidence for possible early autonomic dysfunction in insulin-resistant subjects. Diabetes 1999; 48(6):1295-1299.
171. Lombardi F., Sandrone G., Pempruner S. et al. Heart rate variability as an index of sympathovagal interaction after
myocardial infarction. Am J Cardiol 1987; 60:1239-1245.
172. Lombardi F., Sandrone G., Mortara A. et al. Circadian variation of spectral indices of heart rate variability after myocardial infarction. Am Heart J 1992; 123:1521-1529.
173. Lombardi F., Mortara A. Heart rate variability and cardiac failure. Heart 1998; 80:214-231.
174. Malik M. Heart rate variability. Curr Opin Cardiol 1998; 13:36-44.
175. Malik M., Camm A. J. Components of heart rate variability. What they really mean and what we really measure. Am J
Cardiol 1993; 72:821-822.
176. Malik M., Camm A. J. Heart rate variability and clinical cardiology. Br Heart J 1994; 71:3-6.
177. Malik M., Cripps T., Farrell T., Camm A. J. Prognostic value of heart rate variability after myocardial infarction a
comparison of different data processing methods. Med Biol Eng Comput 1989; 27:603-611.

178. Malliani A. Association of heart rate variability components with physiological regulatory mechanisms. In: Heart rate
variability (Malik, Camm eds). Futura Pub Comp, 1995, 543 .

179. Negoescu R. M., Csiki I. E., Pafnote M., Wolf S. Cortical control of sinus arrhythmia in man studied by spectral analysis. Integr Physiol Behav Sci 1993; 28(3):226-238.

180. demnuyiwa ., Malik M., Farell T. et al. Comparison of the predictive characteristics of heart rate variability index
and left ventricular ejection fraction for all-cause mortality arhythmic events and sudden death after acute myocardial infarction . Am J Cardiol 1991; 68:434-439.
181. Pagani M., Malfatto G., Pierini S. et al. Spectral analysis of heart rate variability in the assessment of autonomic diabetic neuropathy. J Auton Nerv System 1988; 23:143-153.
182. Pedretti R. F., Braga S. S., Colombo E. at al. Prediction for arrhythmic events after acute myocardial infarction by
time and frequency domain measures of heart rate variability. Eur Heart J 1994; 15:81-82.
183. Pedretti R. F., Braga S. S., Laporta A. at al. Heart rate variability after myocardial infarction: a useful tool for predicting of life-threatening ventricular arrhythmias in the thrombolytic era. Eur Heart J 1996; 17:29.
184. Pedretti R. F., Migliori G. B., Mapelli V., Daniele G., Podrid P. J., Tramarin R. Cost-effectiveness analysis of invasive and noninvasive tests in high risk patients treated with amiodarone after acute myocardial infarction. Am J Coll Cardiol 1998; 31(7):1481-1489.
185. Pinna G. D., Maestri R., Di-Cesare A., Colombo R., Minuco G. The accuracy of power-spectrum analysis of heart rate
variability from annotated RR lists generated by Holter systems. Physiol Meas 1994; 15(2):163-179.
186. Puig J., Freitas J., Carvalho M. J., Puga N., Ramos J., Fernandes P., Costa O., de-Freitas A. F. Spectral analysis of
heart rate variability in athletes. J Sports Med Phys Fitness 1993; 33(1):44-48.
187. Reinhardt R. A., Fetsch T., Makijarvi M. at al. Combination f beat-to-beat changes of heart rate and time domain
analysis of the signal-averaged electrocardiogram for non-invasive risk stratification after acute myocardial infarction.
Eur Heart J 1995; 16:431.
188. Sands K. ., Appel M. L., Lilly L. S. et al. Power spectrum analysis of heart rate variability in human cardiac transplant
recipients. Circulation 1989; 79:76-82.
189. Sayers B. . Analysis of heart rate variability. Ergonomics 1973; 16:17-32.
190. Scherer P., Ohier J.P., Hirche H., Hopp H.W. Definition of a new beat-to-beat-parameter of heart rate variability.
(Abstr).Pacing Clin Electrophys 1993; 16:939.
191. Sleight P., Bernardi Z. Sympathovagal balance. Circulation 1998; 98:2640-2644.
192. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophisiology.
Heart Rate Variability. Standarts of measurements, Physiological Interpretation, and Clinical Use. Circulation 1996;
93:1043-1065.
193. Taylor J. A., Carr D. L., Myers C. W., Eckberg D. L. Mechanisms underlying very-low-frequency RR-interval oscillation in humans. Circulation 1998; 98:547-555.
194. Taylor J. A., Eckberg D. L. Fundamental relations between short-term RR interval and arterial pressure oscillations in
humans. Circulation 1996; 93:1527-1532.

110

195. The Multicenter Postinfarction Research Group. Risk stratification after myocardial infarction. N Engl J Med 1983;
309:331-336.

196. Yamamoto Y., Hughson R. L. Coarse-graining spectral analysis: new method for studying heart rate variability. J Appi
Physiol 1991; 71:1143-1150.

197. Van Hoogenhuyze D. K., Weinstein N., Martin G. J. et al. Reproducibility and relation to mean heart rate of heart rate
variability in normal subjects and in patients with congestive heart failure secondary to coronary artery disease. Am J
Cardiol 1991; 68:1668-1676.
198. Voss A., Busjahn A., Wessel N., Schurath R., Faulhaber H. D., Luft F. C., Dietz R. Familial and genetic influences
on heart rate variability. J Electrocardiol 1996; 29:154-160.
199. Wolf M. M., Varigos G. ., Hunt D., Sloman J. G. Sinus arrhythmia in acute myocardial infarction. Med J Australia
1978; 2:52-53.
200. Zotti A. M., Bettinardi O., Soffientino F. et al. Psychophysiological stress testing in postinfarction patients. Circulation
1991; 4:1125-1135.

111