Heart rate variability (HRV) in individuals with autism spectrum disorders (ASD) has been investigated in some studies but the procedures and results vary. We conducted a systematic review and meta-analysis to compare HRV in individuals with and without ASD; the influence of different conditions and HRV indices is considered. Baseline HRV and HRV reactivity were analyzed in several ways: parasympathetic indices in hierarchical order (main analysis), total variability, specific parasympathetic indices and respiratory sinus arrhythmia (RSA), etc. The review covered 34 studies for quantitative analysis. Individuals with ASD had a significantly lower baseline HRV for parasympathetic indices in hierarchical order (Hedges’g=-0.5168, p < 0.0001) and RSA (g=-0.5860, p=0.0010). The reactivity of HRV in situations of social stress (g=-0.4647, p = 0.0033) and social debriefing (g=-0.5001, p = 0.0007) was also significantly lower in subjects with ASD. RSA reactivity was significantly lower in ASD group for all situations, with the largest effect size for social stress (g=-0.7246, p < 0.0001). The results support low HRV to be a potential biomarker of ASD, especially RSA reactivity under social stress.

自闭症谱系障碍（ASD）患者的心率变异性（HRV）已在一些研究中进行了调查，但操作步骤和结果各不相同。我们进行了系统的回顾和荟萃分析，比较有或没有ASD的患者的HRV。考虑不同条件和HRV指数的影响。基线HRV和HRV反应性通过多种方式进行了分析：副交感神经指数（主要分析），总变异性，特定副交感神经指数和呼吸道窦性心律不齐（RSA）等。该综述涵盖了34项定量分析研究。患有ASD的个体的副交感神经指数的基线HRV显着较低，呈等级顺序（Hedges's g = -0.5168，p <0.0001）和RSA（g = -0.5860，p ＝ 0.0010）。在患有自闭症的受试者中，在社交压力（g = -0.4647，p = 0.0033）和社交汇报（g = -0.5001，p = 0.0007）的情况下，HRV的反应性也显着降低。在所有情况下，ASD组的RSA反应性均显着降低，对社会压力的影响最大（g = -0.7246，p <0.0001）。结果支持低HRV成为ASD的潜在生物标志物，尤其是在社会压力下的RSA反应性。