Pitzalis M V, Massari F, Forleo C, Fioretti A, Colombo R, Balducci C, Mastropasqua F, Rizzon P
Institute of Cardiology, University of Bari, Bari, Italy.
Hypertension. 1999 Nov;34(5):1060-5. doi: 10.1161/01.hyp.34.5.1060.
Previous studies have found that respiratory variations of ventricular response in atrial fibrillation are infrequent and inconsistent. This asynchrony between heart rate and respiration may characterize the physiological mechanisms coupling heart rate and systolic blood pressure oscillations in the respiratory band. The aim of this study was to evaluate whether synchronous variations in systolic blood pressure and respiration depend on a simultaneous change in heart rate. Univariate and bivariate spectral analyses were made of the R-R interval, systolic blood pressure, and respiratory signals during controlled respiration (16 breaths/min) in 24 patients with atrial fibrillation before and after efficacious electrical cardioversion and in 24 age- and sex-matched control subjects. During atrial fibrillation, the spectral coherence between respiration and heart rate was low (0.18+/-0.03), but there was a high level of coherence between respiration and systolic blood pressure (0.67+/-0.05). After cardioversion, the coherence between respiration and heart rate increased to 0.86+/-0.04, whereas the geometric mean values of the concomitant respiratory systolic blood pressure oscillations decreased by 72% (from 21.1 to 5.9 mm Hg(2), P<0.001), which was similar to that observed in the control group (5. 7 mm Hg(2)). These results confirm the inconsistent effect of respiration on heart rate response during atrial fibrillation and demonstrate that respiratory sinus arrhythmia is not a prerequisite for systolic blood pressure oscillations but may play an antioscillatory role in respiratory systolic blood pressure variability, which is probably mediated by arterial baroreflex mechanisms.
先前的研究发现，心房颤动时心室反应的呼吸变化并不常见且不一致。心率与呼吸之间的这种不同步可能是呼吸频段中心率与收缩压振荡耦合的生理机制的特征。本研究的目的是评估收缩压与呼吸的同步变化是否取决于心率的同时变化。对24例心房颤动患者在有效电复律前后以及24例年龄和性别匹配的对照受试者在控制呼吸（16次/分钟）期间的R-R间期、收缩压和呼吸信号进行了单变量和双变量频谱分析。在心房颤动期间，呼吸与心率之间的频谱相干性较低（0.18±0.03），但呼吸与收缩压之间存在高度相干性（0.67±0.05）。电复律后，呼吸与心率之间的相干性增加到0.86±0.04，而伴随的呼吸性收缩压振荡的几何平均值下降了72%（从21.1降至5.9 mmHg²，P<0.001），这与对照组中观察到的情况相似（5.7 mmHg²）。这些结果证实了心房颤动期间呼吸对心率反应的影响不一致，并表明呼吸性窦性心律不齐不是收缩压振荡的先决条件，但可能在呼吸性收缩压变异性中起抗振荡作用，这可能是由动脉压力反射机制介导的。
