Baselli Giuseppe, Porta Alberto, Pagani Massimo
Department of Bioengineering, Politecnico di Milano, Milan, Italy.
IEEE Trans Biomed Eng. 2006 Jan;53(1):53-64. doi: 10.1109/TBME.2005.859787.
Arterial pressure (AP) and heart rate (HR) waves have long been recognized as an important sign of cardiovascular regulation, however, the underlying interactions involving vasomotion, arterial mechanisms and neural regulation have not been clarified. With the aid of simple dynamical models consisting of active peripheral vascular districts (PVDs) fed by a compliant/resistant arterial tree, the relationship between local AP and flow and systemic AP waves were analyzed. A PVD was described as a nonlinear flow regulation loop. Various feedback dynamics were experimented and general properties were focused. The PVDs displayed a region of active flow compensation against pressure changes, in which self-sustained low-frequency (LF, 0.1 Hz) appeared. Oscillations critically depended on parameter, Teq, analogous to a windkessel time constant, proportional to arterial compliances: a value of about 2 s (consistent with a normal pulse pressure) performed a buffering effect essential for LF oscillations in peripheral flow; conversely, stiffer arteries damped LF vasomotion. Two PVDs fed by a common compliance oscillated in phase opposition; the consequent negative interference cancelled systemic AP waves, even in presence of large peripheral oscillations. The partial disruption of phase opposition by a common neural drive oscillating at a LF proximal to that of the PVDs unveiled LF waves in AP. Also, several PVDs with randomly different natural frequencies displayed a tendency to reciprocal cancellation, while a limited neurally induced phase alignment unmasked LF oscillations at systemic level. It is concluded that vasomotion, arterial compliances and, neural drives are all elements which may cooperate in forming AP waves.
动脉压(AP)和心率(HR)波形长期以来一直被认为是心血管调节的重要标志,然而,涉及血管运动、动脉机制和神经调节的潜在相互作用尚未阐明。借助由顺应性/阻力性动脉树供血的活性外周血管区(PVD)组成的简单动力学模型,分析了局部AP与血流以及全身AP波形之间的关系。一个PVD被描述为一个非线性血流调节回路。对各种反馈动力学进行了实验,并关注了其一般特性。PVD显示出一个针对压力变化的活性血流补偿区域,其中出现了自持低频(LF,0.1Hz)。振荡严重依赖于参数Teq,类似于风箱时间常数,与动脉顺应性成正比:约2秒的值(与正常脉压一致)对外周血流中的LF振荡起到了至关重要的缓冲作用;相反,动脉更硬会抑制LF血管运动。由共同顺应性供血的两个PVD以相反相位振荡;由此产生的负干扰消除了全身AP波形,即使在存在较大外周振荡的情况下也是如此。由与PVD的低频相近的低频振荡的共同神经驱动对相位相反的部分破坏揭示了AP中的LF波形。此外,几个具有随机不同固有频率的PVD显示出相互抵消的趋势,而有限的神经诱导相位对齐在全身水平上揭示了LF振荡。得出的结论是,血管运动、动脉顺应性和神经驱动都是可能共同作用形成AP波形的要素。