Stewart Julian M, Montgomery Leslie D, Glover June L, Medow Marvin S
Professor of Pediatrics and Physiology, Research Division and Hypotension Laboratory, New York Medical College, Suite 3050, 19 Bradhurst Ave., Hawthorne, NY 10532, USA.
Am J Physiol Heart Circ Physiol. 2007 Jan;292(1):H215-23. doi: 10.1152/ajpheart.00681.2006. Epub 2006 Aug 25.
Increased blood pressure (BP) and heart rate during exercise characterizes the exercise pressor reflex. When evoked by static handgrip, mechanoreceptors and metaboreceptors produce regional changes in blood volume and blood flow, which are incompletely characterized in humans. We studied 16 healthy subjects aged 20-27 yr using segmental impedance plethysmography validated against dye dilution and venous occlusion plethysmography to noninvasively measure changes in regional blood volumes and blood flows. Static handgrip while in supine position was performed for 2 min without postexercise ischemia. Measurements of heart rate and BP variability and coherence analyses were used to examine baroreflex-mediated autonomic effects. During handgrip exercise, systolic BP increased from 120 +/- 10 to 148 +/- 14 mmHg, whereas heart rate increased from 60 +/- 8 to 82 +/- 12 beats/min. Heart rate variability decreased, whereas BP variability increased, and transfer function amplitude was reduced from 18 +/- 2 to 8 +/- 2 ms/mmHg at low frequencies of approximately 0.1 Hz. This was associated with marked reduction of coherence between BP and heart rate (from 0.76 +/- 0.10 to 0.26 +/- 0.05) indicative of uncoupling of heart rate regulation by the baroreflex. Cardiac output increased by approximately 18% with a 4.5% increase in central blood volume and an 8.5% increase in total peripheral resistance, suggesting increased cardiac preload and contractility. Splanchnic blood volume decreased reciprocally with smaller decreases in pelvic and leg volumes, increased splanchnic, pelvic and calf peripheral resistance, and evidence for splanchnic venoconstriction. We conclude that the exercise pressor reflex is associated with reduced baroreflex cardiovagal regulation and driven by increased cardiac output related to enhanced preload, cardiac contractility, and splanchnic blood mobilization.
运动期间血压(BP)和心率升高是运动升压反射的特征。当由静态握力诱发时,机械感受器和代谢感受器会引起血容量和血流的局部变化,而这些变化在人体中的特征尚未完全明确。我们使用经染料稀释和静脉闭塞体积描记法验证的节段阻抗体积描记法,对16名年龄在20 - 27岁的健康受试者进行研究,以无创测量局部血容量和血流的变化。受试者在仰卧位进行2分钟的静态握力运动,且运动后无缺血情况。通过测量心率和血压变异性以及进行相干分析,来检查压力反射介导的自主神经效应。在握力运动期间,收缩压从120±10 mmHg升高至148±14 mmHg,而心率从60±8次/分钟增加到82±12次/分钟。心率变异性降低,而血压变异性增加,在约0.1 Hz的低频下,传递函数幅度从18±2 ms/mmHg降至8±2 ms/mmHg。这与血压和心率之间的相干性显著降低(从0.76±0.10降至0.26±0.05)相关,表明压力反射对心率调节的解耦。心输出量增加约18%,中心血容量增加4.5%,总外周阻力增加8.5%,提示心脏前负荷和收缩力增加。内脏血容量相应减少,盆腔和腿部血容量减少幅度较小,内脏、盆腔和小腿外周阻力增加,并有内脏静脉收缩的证据。我们得出结论,运动升压反射与压力反射性心迷走神经调节减弱有关,并且由与前负荷增加、心脏收缩力增强和内脏血液动员相关的心输出量增加所驱动。