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动脉和心肺总外周阻力压力反射增益值的估计:通过慢性动脉压力感受器去神经支配进行验证。

Estimation of arterial and cardiopulmonary total peripheral resistance baroreflex gain values: validation by chronic arterial baroreceptor denervation.

作者信息

Mukkamala Ramakrishna, Kim Jong-Kyung, Li Ying, Sala-Mercado Javier, Hammond Robert L, Scislo Tadeusz J, O'Leary Donal S

机构信息

Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824, USA.

出版信息

Am J Physiol Heart Circ Physiol. 2006 May;290(5):H1830-6. doi: 10.1152/ajpheart.00898.2005. Epub 2005 Nov 23.

Abstract

Feedback control of total peripheral resistance (TPR) by the arterial and cardiopulmonary baroreflex systems is an important mechanism for short-term blood pressure regulation. Existing methods for measuring this TPR baroreflex mechanism typically aim to quantify only the gain value of one baroreflex system as it operates in open-loop conditions. As a result, the normal, integrated functioning of the arterial and cardiopulmonary baroreflex control of TPR remains to be fully elucidated. To this end, the laboratory of Mukkamala et al. (Mukkamala R, Toska K, and Cohen RJ. Am J Physiol Heart Circ Physiol 284: H947-H959, 2003) previously proposed a potentially noninvasive technique for estimating the closed-loop (dimensionless) gain values of the arterial TPR baroreflex (GA) and the cardiopulmonary TPR baroreflex (GC) by mathematical analysis of the subtle, beat-to-beat fluctuations in arterial blood pressure, cardiac output, and stroke volume. Here, we review the technique with additional details and describe its experimental evaluation with respect to spontaneous hemodynamic variability measured from seven conscious dogs, before and after chronic arterial baroreceptor denervation. The technique was able to correctly predict the group-average changes in GA and GC that have previously been shown to occur following chronic arterial baroreceptor denervation. That is, reflex control by the arterial TPR baroreflex was virtually abolished (GA = -2.1 +/- 0.6 to 0.3 +/- 0.2; P < 0.05), while reflex control by the cardiopulmonary TPR baroreflex more than doubled (GC = -0.7 +/- 0.4 to -1.8 +/- 0.2; P < 0.05). With further successful experimental testing, the technique may ultimately be employed to advance the basic understanding of TPR baroreflex functioning in both humans and animals in health and disease.

摘要

动脉和心肺压力反射系统对总外周阻力(TPR)的反馈控制是短期血压调节的重要机制。现有的测量这种TPR压力反射机制的方法通常仅旨在量化一个压力反射系统在开环条件下运行时的增益值。因此,动脉和心肺对TPR的压力反射控制的正常、综合功能仍有待充分阐明。为此,Mukkamala等人的实验室(Mukkamala R、Toska K和Cohen RJ。《美国生理学杂志:心脏和循环生理学》284:H947 - H959,2003)此前提出了一种潜在的非侵入性技术,通过对动脉血压、心输出量和每搏输出量的细微逐搏波动进行数学分析,来估计动脉TPR压力反射(GA)和心肺TPR压力反射(GC)的闭环(无量纲)增益值。在此,我们详细回顾该技术,并描述其针对七只清醒犬在慢性动脉压力感受器去神经前后测量的自发血流动力学变异性的实验评估。该技术能够正确预测先前已显示在慢性动脉压力感受器去神经后发生的GA和GC的组平均变化。也就是说,动脉TPR压力反射的反射控制几乎被消除(GA = -2.1 ± 0.6至0.3 ± 0.2;P < 0.05),而心肺TPR压力反射的反射控制增加了一倍多(GC = -0.7 ± 0.4至 -1.8 ± 0.2;P < 0.05)。随着进一步成功的实验测试,该技术最终可能被用于增进对健康和疾病状态下人类和动物TPR压力反射功能的基本理解。

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