人体动态运动期间房室传导的逐搏调节
Beat-to-beat modulation of atrioventricular conduction during dynamic exercise in humans.
作者信息
Nakamoto Tomoko, Matsukawa Kanji, Murata Jun, Komine Hidehiko
机构信息
Department of Physiology, Graduate School of Health Sciences, Hiroshima University, Minami-ku, Hiroshima, 734-8551 Japan.
出版信息
Jpn J Physiol. 2005 Feb;55(1):37-51. doi: 10.2170/jjphysiol.R2089.
A complex balance between extrinsic neural and intrinsic mechanisms is responsible for regulating atrioventricular (AV) conduction. We hypothesized that atrial excitation interval is shortened during dynamic exercise by extrinsic cardiac autonomic activity and that if AV conduction time responds inversely to fluctuation in atrial rhythm, ventricular excitation interval will be maintained at the predetermined cardiac cycle length. To examine such inverse relationship between PP interval and the subsequent change in PR interval (DeltaPR), we analyzed the beat-to-beat changes in PP, PR, and RR intervals during stair-stepping exercise for 10 min in 11 sedentary and 9 trained subjects. In the sedentary group, the average PR interval significantly shortened during exercise, in parallel with the reduction in the average PP and RR intervals. The variance of PP and RR intervals was also significantly decreased during exercise. The reduction in the variance of RR interval was, however, much greater than that of PP interval, implying that AV conduction time changes inversely to fluctuation in atrial excitation rhythm. Indeed, the variance of PR interval was augmented during exercise and there was a clear inverse relationship between PP and DeltaPR intervals. Although trained subjects were characterized by their lower heart rate response during dynamic exercise, the responses in the variability of PP, PR, and RR intervals were fundamentally identical with those in sedentary subjects. We conclude that the AV nodal mechanism that operates at a higher level of heart rate during dynamic exercise may cancel fluctuation in atrial excitation interval and keep ventricular excitation rhythm at the predetermined cardiac cycle length.
外在神经机制和内在机制之间的复杂平衡负责调节房室(AV)传导。我们假设在动态运动期间,外在心脏自主神经活动会缩短心房兴奋间期,并且如果房室传导时间对心房节律的波动呈反向反应,心室兴奋间期将维持在预定的心动周期长度。为了研究PP间期与随后PR间期变化(ΔPR)之间的这种反向关系,我们分析了11名久坐不动的受试者和9名训练有素的受试者在进行10分钟登楼梯运动期间PP、PR和RR间期的逐搏变化。在久坐不动的组中,运动期间平均PR间期显著缩短,同时平均PP和RR间期也减少。运动期间PP和RR间期的方差也显著降低。然而,RR间期方差的降低幅度远大于PP间期,这意味着房室传导时间与心房兴奋节律的波动呈反向变化。事实上,运动期间PR间期的方差增大,并且PP与ΔPR间期之间存在明显的反向关系。尽管训练有素的受试者在动态运动期间心率反应较低,但其PP、PR和RR间期变异性的反应与久坐不动的受试者基本相同。我们得出结论,在动态运动期间以较高心率水平运作的房室结机制可能抵消心房兴奋间期的波动,并将心室兴奋节律维持在预定的心动周期长度。