Piha S J, Seppänen A
Rehabilitation Research Centre of the Social Insurance Institution, Turku, Finland.
Clin Auton Res. 1991 Dec;1(4):289-96. doi: 10.1007/BF01819834.
Observations on 1,282 measurements of non-invasive cardiovascular reflex testing of autonomic function in 1,023 control subjects and patients with different disorders are presented. It is suggested that the Valsalva manoeuvre be performed three times rather than once and the highest Valsalva ratio should be used instead of the mean or first of the three ratios. The deep breathing test gives equally reliable information when three breathing cycles are used instead of six. Symptoms were detected in up to 15% of the subjects depending on the test, although the majority of these were minor and transient. The frequency of ventricular/supraventricular extrasystoles increased especially during the Valsalva manoeuvre (+67%/+40%) and post-strain (+49%/+25%) phases and early recovery phase of the orthostatic test (+69%/+156%) and to a lesser degree during deep breathing (+18%/+50%) and handgrip (+36%/-11%) phases compared with the resting phase. However, severe cardiac rhythm disturbances were very rare. 1-2% of the younger (less than 50 years) and 10% of the older subjects were not able to perform the tests adequately. The R-R intervals on which the results are based should be selected carefully, and use of a continuous non-invasive method of blood pressure monitoring should provide further useful information.
本文呈现了对1023名对照受试者和患有不同疾病的患者进行的1282次自主神经功能无创心血管反射测试的观察结果。建议进行瓦尔萨尔瓦动作三次而非一次，应使用最高的瓦尔萨尔瓦比率而非三个比率的平均值或第一个比率。当使用三个呼吸周期而非六个呼吸周期时，深呼吸测试能提供同样可靠的信息。根据测试不同，高达15%的受试者检测到症状，不过其中大多数症状轻微且短暂。与静息期相比，室性/室上性期前收缩的频率在瓦尔萨尔瓦动作期间（分别增加67%/40%）、动作后（分别增加49%/25%）以及直立倾斜试验的早期恢复期（分别增加69%/156%）时尤其增加，在深呼吸期间（分别增加18%/50%）和握力试验期间（分别增加36%/-11%）时增加程度较小。然而，严重的心律失常非常罕见。1 - 2%的年轻受试者（小于50岁）和10%的老年受试者无法充分完成测试。应仔细选择作为结果依据的R - R间期，使用连续无创血压监测方法应能提供更多有用信息。
