Aljuri Nikolai, Cohen Richard J
Harvard-Massachusetts Institute of Technology, 45 Carleton St., E25-335, Cambridge, MA 02142, USA.
Am J Physiol Heart Circ Physiol. 2004 Nov;287(5):H2252-73. doi: 10.1152/ajpheart.00489.2003. Epub 2004 Jul 1.
The most important goal of this study is to enhance our understanding of the crucial functional relationships that determine the behavior of the systemic circulation and its underlying physiological regulatory mechanisms with minimal modeling. To the present day, much has been said about the indirect hydraulic effects of right atrial pressure (PRA) via cardiac output (CO) on arterial pressure (Pa) through the heart and pulmonary circulation or the direct regulatory effects of PRA on Pa through the cardiopulmonary baroreflex; however, very little attention has been given to the hydraulic influence that PRA exerts directly through the systemic circulation. The experimental data reported by Guyton et al. in 1957 demonstrated that steady-state PRA and the rate at which blood passes through the systemic circulation are locked in a functional relationship independent of any consequence of altered PRA on cardiac function. With this in mind, we emphasize the analytic algebraic analysis of the systemic circulation composed of arteries, veins, and its underlying physiological regulatory mechanisms of baroreflex and autoregulatory modulation of total peripheral resistance (TPR), where the behavior of the system can be analytically synthesized from an understanding of its minimal elements. As a result of this analysis, we present a novel mathematical method to determine short-term TPR fluctuations, which accounts for the entirety of observed Pa fluctuations, and propose a new cardiovascular system identification method to delineate the actual actions of the physiological mechanisms responsible for the dynamic couplings between CO, Pa, PRA, and TPR in an individual subject.
本研究的最重要目标是,通过最少的建模来增强我们对决定体循环行为及其潜在生理调节机制的关键功能关系的理解。时至今日,关于右心房压力(PRA)通过心输出量(CO)经心脏和肺循环对动脉压(Pa)产生的间接液压效应,或者PRA通过心肺压力反射对Pa产生的直接调节效应,已经有很多论述;然而,PRA通过体循环直接施加的液压影响却很少受到关注。1957年Guyton等人报告的实验数据表明,稳态PRA与血液流经体循环的速率处于一种功能关系中,这种关系独立于PRA改变对心脏功能的任何影响。考虑到这一点,我们强调对由动脉、静脉组成的体循环及其压力反射和总外周阻力(TPR)的自动调节调制的潜在生理调节机制进行解析代数分析,在这种分析中,系统的行为可以从对其最小元素的理解中进行解析合成。基于这一分析结果,我们提出了一种确定短期TPR波动的新颖数学方法,该方法考虑了观察到的Pa波动的全部情况,并提出了一种新的心血管系统识别方法,以描绘在个体受试者中负责CO、Pa、PRA和TPR之间动态耦合的生理机制的实际作用。