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长期运动训练对心脏自主神经活动和压力反射敏感性的影响。

Effects of long-term exercise training on cardiac autonomic nervous activities and baroreflex sensitivity.

作者信息

Ueno Linda Massako, Moritani Toshio

机构信息

Laboratory of Applied Physiology, Graduate School of Human and Environmental Studies, Kyoto University, Sakyo-ku, 606-8501 Kyoto, Japan.

出版信息

Eur J Appl Physiol. 2003 Apr;89(2):109-14. doi: 10.1007/s00421-002-0777-z. Epub 2003 Feb 28.

Abstract

Reductions in tonic vagal controls of the heart and depressed baroreflex sensitivity (BRS) have been associated with a postural fall in blood pressure (BP) and the incidence of cardiac events among older people. We examined the hypothesis that BP regulation during orthostatic challenge as well as heart rate variability (HRV) at rest can be better maintained in long-term exercise-trained, healthy, older men (aged 60-70 years). Subjects were classified into two groups; long-term exercise-trained (LTET, n=14) and sedentary (SED, n=10) according to their history of physical activity. Prior to the dynamic BRS assessment, supine resting autonomic cardiac modulation was assessed by means of time domain HRV [standard deviation of ECG R-R interval (RRISD) and the coefficient of variation (CV)]. The BRS was assessed during 60 degrees head-up tilting by simultaneously measuring beat-by-beat systolic blood pressure (SBP) and ECG R-R interval changes. The BRS gain was determined by the regression slope coefficient based on the extent of the SBP fall and the corresponding ECG R-R shortening during the orthostatic challenge. The results indicated that the LTET group manifested greater ECG R-R interval fluctuations with significantly higher resting RRISD and CV, compared with the SED group [59.5 (10.4) versus 27.7 (7.8) ms, p<0.05; 5.5 (0.8) versus 2.8 (0.7)%, p<0.05], respectively. Using dynamic BRS testing during the acute orthostatic challenge, the LTET group showed a significantly higher BRS gain than the SED [6.4 (0.8) versus 3.8 (0.6) ms x mmHg(-1), p<0.017] group. These results indicate that CV and BRS are well maintained in healthy, LTET older individuals when compared with their sedentary peers. Our data suggest that this augmented autonomic cardiac modulation reflects better parasympathetic responsiveness in LTET individuals. Data provide further support for long-term exercise training as another possible cardioprotective factor that might decrease susceptibility to ventricular fibrillation as well as assist arterial BP at the onset of an orthostatic challenge in older men.

摘要

心脏迷走神经张力控制的降低和压力反射敏感性(BRS)的下降与老年人的体位性血压(BP)下降及心脏事件的发生率相关。我们检验了这样一个假设:长期进行运动训练的健康老年男性(年龄60 - 70岁)在直立应激期间的血压调节以及静息心率变异性(HRV)能够得到更好的维持。根据体力活动史,将受试者分为两组:长期运动训练组(LTET,n = 14)和久坐组(SED,n = 10)。在进行动态BRS评估之前,通过时域HRV [心电图R - R间期标准差(RRISD)和变异系数(CV)]评估仰卧位静息自主心脏调节。在60度头高位倾斜期间,通过同时测量逐搏收缩压(SBP)和心电图R - R间期变化来评估BRS。BRS增益由基于直立应激期间SBP下降程度和相应心电图R - R间期缩短程度的回归斜率系数确定。结果表明,与SED组相比,LTET组表现出更大的心电图R - R间期波动,静息RRISD和CV显著更高[分别为59.5(10.4)对27.7(7.8)ms,p < 0.05;5.5(0.8)对2.8(0.7)%,p < 0.05]。在急性直立应激期间使用动态BRS测试,LTET组的BRS增益显著高于SED组[6.4(0.8)对3.8(0.6)ms·mmHg⁻¹,p < 0.017]。这些结果表明,与久坐的同龄人相比,健康的LTET老年个体的CV和BRS得到了很好的维持。我们的数据表明,这种增强的自主心脏调节反映了LTET个体更好的副交感神经反应性。数据进一步支持长期运动训练是另一个可能的心脏保护因素,它可能降低老年男性心室颤动的易感性,并在直立应激开始时辅助动脉血压。

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