Leung Richard S T, Bradley T Douglas
Toronto General Hospital/University Health Network, Centre for Sleep Medicine and Circadian Biology, University of Toronto, Ontario, Canada.
J Electrocardiol. 2003;36 Suppl:213-7. doi: 10.1016/j.jelectrocard.2003.09.062.
Cheyne-Stokes respiration (CSR) is a form of periodic breathing associated with oscillations in heart rate (HR) and blood pressure (BP), which have previously been attributed to the effects of intermittent hypoxia and arousals from sleep. We herein review the major findings from a series of experiments, in which we explored the possibility that the ventilatory oscillations of CSR can independently modulate HR and BP. Using frequency spectral analysis, we showed that CSR in patients with heart failure causes oscillations in HR and BP that are eliminated by abolition of ventilatory oscillations, but persist during administration of supplemental O2 sufficient to prevent hypoxia. Analysis of the effects of arousals showed they have little or no effect on HR or BP independent of associated changes in ventilation. Finally, we showed that during simulated CSR, healthy awake patients were able to cause HR and BP oscillations in the absence of hypoxia or arousals. We conclude that ventilatory oscillations during Cheyne-Stokes respiration can modulate HR and BP independent of the effects of hypoxia and arousals from sleep.
潮式呼吸（CSR）是一种周期性呼吸形式，与心率（HR）和血压（BP）的波动有关，此前这些波动被认为是间歇性缺氧和睡眠中觉醒的影响所致。我们在此回顾了一系列实验的主要发现，在这些实验中，我们探讨了潮式呼吸的通气波动能够独立调节心率和血压的可能性。通过频谱分析，我们发现心力衰竭患者的潮式呼吸会导致心率和血压波动，而通气波动的消除可消除这些波动，但在给予足以预防缺氧的补充氧气期间，这些波动仍然存在。对觉醒影响的分析表明，它们对心率或血压几乎没有独立于通气相关变化的影响。最后，我们表明，在模拟潮式呼吸期间，健康清醒的患者能够在无缺氧或觉醒的情况下引起心率和血压波动。我们得出结论，潮式呼吸期间的通气波动可独立于缺氧和睡眠中觉醒的影响来调节心率和血压。
