Lino S, Calcagnini G, Censi F, Congi M, De Pasquale F
Servizio Speciale di Fisiopatologia Clinica, Università degli Studi La Sapienza, Roma.
Cardiologia. 1999 Mar;44(3):281-7.
Studies using spectral analysis of cardiovascular variability series, as a non invasive tool for assessing the autonomic nervous system activity, have attracted growing interest in the last 20 years. Short-term recordings of heart rate variability distinguish two main spectral components: a high-frequency (HF) component (ranging between 0.15-0.40 Hz), and a low-frequency (LF) component (ranging between 0.04-0.15 Hz), respectively considered markers of parasympathetic and sympathetic control. Spectral analysis of microcirculatory blood flow, by using laser Doppler flowmetry, recently disclosed the presence of similar rhythms. Although a general agreement about the amplitude and frequency of these spectral components has not been gained yet, evidences of an autonomic nervous system role have been collected. Also the pupil diameter spontaneously fluctuates in the HF range. The aim of this study was to design an experimental set up for the simultaneous and continuous recording of heart rate, blood pressure, respiratory activity, peripheral blood flow, and pupil diameter fluctuations in order to investigate whether common spontaneous rhythms could be detected into the variability series. We enrolled 10 normal volunteers (range 24-28 years). The variability series of heart rate, blood pressure, respiratory activity, peripheral blood flow and pupil diameter were obtained at rest and during sympathetic activation by head-up tilt test 70 degrees. Subjects were instructed to breath at 15 breath/min following an audio signal and adjusting their tidal volume to a comfortable level. Peripheral blood flow was non invasively monitored with laser Doppler technique, with the two probes located in the palmar site of the hand and in the sternum. We continuously assess the pupil diameter fluctuations by a custom, portable, infrared TV pupillometer. Spectral density was estimated by autoregressive modeling on 250-point segments. The respiratory rhythm was clearly detected in all the variability series. Oscillations in the LF band were detected in heart rate, blood pressure and in the laser Doppler signals of the hand, as well as in the pupil diameter, but not always in the laser Doppler flow of the sternum. In this last signal an harmonic component at 0.16-0.17 Hz was detected. A reduction in the total variability, with a relative increase in the LF component was observed during head-up tilt test in the heart rate, blood pressure, peripheral blood flow and pupil diameter signals. These findings are consistent with the increased sympathetic modulation induced by the head-up tilt test. These data confirm previous findings and observations, collected with different techniques and for different purposes. Whether these rhythms can be expression of central common oscillators or reflex mechanical factors is of primary importance for possible clinical applications of this approach.
在过去20年中,利用心血管变异性系列的频谱分析作为评估自主神经系统活动的非侵入性工具的研究引起了越来越多的关注。心率变异性的短期记录可区分两个主要频谱成分:高频(HF)成分(范围在0.15 - 0.40赫兹之间)和低频(LF)成分(范围在0.04 - 0.15赫兹之间),分别被视为副交感神经和交感神经控制的标志物。最近,通过激光多普勒血流仪对微循环血流进行频谱分析,发现了类似的节律。尽管尚未就这些频谱成分的幅度和频率达成普遍共识,但已收集到自主神经系统作用的证据。瞳孔直径也在高频范围内自发波动。本研究的目的是设计一种实验装置,用于同时连续记录心率、血压、呼吸活动、外周血流和瞳孔直径波动,以研究是否能在变异性系列中检测到共同的自发节律。我们招募了10名正常志愿者(年龄范围24 - 28岁)。在静息状态和通过70度头高位倾斜试验进行交感神经激活期间,获取心率、血压、呼吸活动、外周血流和瞳孔直径的变异性系列。受试者按照音频信号以每分钟15次呼吸的频率呼吸,并将潮气量调整到舒适水平。用激光多普勒技术非侵入性监测外周血流,两个探头分别位于手掌部位和胸骨处。我们通过定制的便携式红外电视瞳孔计连续评估瞳孔直径波动。通过对250个点的片段进行自回归建模来估计频谱密度。在所有变异性系列中均清晰检测到呼吸节律。在心率、血压、手部激光多普勒信号以及瞳孔直径中检测到低频带的振荡,但在胸骨处的激光多普勒血流中并非总是能检测到。在最后这个信号中检测到一个0.16 - 0.17赫兹的谐波成分。在头高位倾斜试验期间,在心率、血压、外周血流和瞳孔直径信号中观察到总变异性降低,低频成分相对增加。这些发现与头高位倾斜试验引起的交感神经调制增加一致。这些数据证实了先前用不同技术和出于不同目的收集的发现和观察结果。这些节律是否能表达中枢共同振荡器或反射机械因素,对于该方法可能的临床应用至关重要。