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静态运动期间肌肉代谢反射对窦房结调节的作用:心率变异性频谱分析的见解

Muscle metaboreflex contribution to sinus node regulation during static exercise: insights from spectral analysis of heart rate variability.

作者信息

Iellamo F, Pizzinelli P, Massaro M, Raimondi G, Peruzzi G, Legramante J M

机构信息

Dipartimento di Medicina Interna, Università di Roma "Tor Vergata," Rome, Italy.

出版信息

Circulation. 1999 Jul 6;100(1):27-32. doi: 10.1161/01.cir.100.1.27.

Abstract

BACKGROUND

It is currently assumed that during static exercise, central command increases heart rate (HR) through a decrease in parasympathetic activity, whereas the muscle metaboreflex raises blood pressure (BP) only through an increase in sympathetic outflow to blood vessels, because when the metaboreflex activation is maintained during postexercise muscle ischemia, BP remains elevated while HR recovers. We tested the hypotheses that the muscle metaboreflex contributes to HR regulation during static exercise via sympathetic activation and that the arterial baroreflex is involved in the HR recovery of postexercise muscle ischemia.

METHODS AND RESULTS

Eleven healthy male volunteers performed 4-minute static leg extension (SLE) at 30% of maximal voluntary contraction, followed by 4-minute arrested leg circulation (ALC). Autonomic regulation of HR was investigated by spectral analysis of HR variability (HRV), and baroreflex control of heart period was assessed by the spontaneous baroreflex method. SLE resulted in a significant increase in the low-frequency component of HRV that remained elevated during ALC. The normalized high-frequency component of HRV was reduced during SLE and returned to control levels during ALC. Baroreflex sensitivity was significantly reduced during SLE and returned to control levels during ALC when BP was kept elevated above the resting level while HR recovered.

CONCLUSIONS

The muscle metaboreflex contributes to HR regulation during static exercise via a sympathetic activation. The bradycardia that occurs during postexercise muscle ischemia despite the maintained sympathetic stimulus may be explained by a baroreflex-mediated increase in parasympathetic outflow to the sinoatrial node that overpowers the metaboreflex-induced cardiac sympathetic activation.

摘要

背景

目前认为,在静态运动期间,中枢指令通过降低副交感神经活动来增加心率(HR),而肌肉代谢反射仅通过增加对血管的交感神经输出量来升高血压(BP),因为在运动后肌肉缺血期间维持代谢反射激活时,血压保持升高而心率恢复。我们检验了以下假设:肌肉代谢反射在静态运动期间通过交感神经激活参与心率调节,并且动脉压力反射参与运动后肌肉缺血时的心率恢复。

方法与结果

11名健康男性志愿者以最大自主收缩力的30%进行4分钟的静态腿部伸展(SLE),随后进行4分钟的腿部循环阻断(ALC)。通过心率变异性(HRV)的频谱分析研究心率的自主调节,并通过自发性压力反射方法评估压力反射对心动周期的控制。SLE导致HRV的低频成分显著增加,在ALC期间仍保持升高。HRV的标准化高频成分在SLE期间降低,并在ALC期间恢复到对照水平。在SLE期间压力反射敏感性显著降低,在ALC期间当血压保持高于静息水平而心率恢复时,压力反射敏感性恢复到对照水平。

结论

肌肉代谢反射在静态运动期间通过交感神经激活参与心率调节。运动后肌肉缺血期间尽管交感神经刺激持续存在,但出现的心动过缓可能是由于压力反射介导的副交感神经向窦房结的输出增加,其超过了代谢反射诱导的心脏交感神经激活。

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