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[一种评估人体交感神经压力反射功能的新型自发方法]

[A new, spontaneous method for assessing sympathetic baroreflex function in humans].

作者信息

Gallet C, Gujic M, Laude D, van de Borne P, Julien C

机构信息

Unité de neurocardiologie, université Lyon-1, 8, avenue Rockefeller, 69008 Lyon, France.

出版信息

Ann Cardiol Angeiol (Paris). 2012 Jun;61(3):188-92. doi: 10.1016/j.ancard.2012.04.010. Epub 2012 May 7.

Abstract

In humans, assessment of the sympathetic component of the arterial baroreceptor reflex (sBRS) is usually based on microneurographic recordings of muscle sympathetic nerve activity (MSNA), while inducing reflex changes with intravenous administration of vasoactive drugs (modified Oxford method). This method has several limitations, among which its poor temporal resolution. Some studies have proposed alternative methods by using spontaneous changes in arterial pressure (AP) and MSNA, usually collected under baroreflex closed-loop conditions (AP alters MSNA while MSNA alters AP), which makes the results difficult to interpret. In rats, a method has been developed and validated (Kanbar et al., 2007 [1]), which uses oscillations of renal SNA at the frequency of the heart beat. At this frequency, the baroreflex operates under open-loop conditions because of the low-pass filter properties of the resistance vasculature. The goal of the present study was to examine whether this method is applicable in humans. Data were previously collected by Gujic et al. (2007) [2]. Briefly, MSNA and AP were recorded in 16 young healthy subjects during a 5-minute baseline resting period then during a modified Oxford test (sodium nitroprusside and phenylephrine administrations). Using the 5-minute baseline recordings, spontaneous sBRS was assessed through empirical mode decomposition over consecutive 20-second periods. Spontaneous sBRS was significantly related to pharmacological sBRS (R=0.67, n=16, P=0.004). During the 5-minute period, spontaneous sBRS exhibited variations (CV=21.7±1.7%) that were negatively correlated with AP in five subjects (R=-0.61±0.03, P<0.05) and positively correlated with MSNA in ten subjects (R=0.73±0.03, P<0.05). The new method is able to correctly estimate sBRS, and reveals the existence of previously unrecognized fast fluctuations of sBRS.

摘要

在人类中,动脉压力感受器反射(sBRS)交感神经成分的评估通常基于肌肉交感神经活动(MSNA)的微神经图记录,同时通过静脉注射血管活性药物来诱发反射变化(改良牛津法)。该方法存在若干局限性,其中时间分辨率较差。一些研究提出了替代方法,利用动脉血压(AP)和MSNA的自发变化,这些变化通常在压力反射闭环条件下收集(AP改变MSNA,而MSNA改变AP),这使得结果难以解释。在大鼠中,已开发并验证了一种方法(Kanbar等人,2007年[1]),该方法利用肾交感神经活动(SNA)在心跳频率下的振荡。在此频率下,由于阻力血管系统的低通滤波特性,压力反射在开环条件下运行。本研究的目的是检验该方法是否适用于人类。数据先前由Gujic等人(2007年)[2]收集。简而言之,在16名年轻健康受试者的5分钟基线静息期以及改良牛津试验(注射硝普钠和去氧肾上腺素)期间记录MSNA和AP。利用5分钟的基线记录,通过经验模式分解在连续的20秒时间段内评估自发sBRS。自发sBRS与药理学sBRS显著相关(R = 0.67,n = 16,P = 0.004)。在5分钟期间,自发sBRS表现出变化(CV = 21.7±1.7%),在五名受试者中与AP呈负相关(R = -0.61±0.03,P < 0.05),在十名受试者中与MSNA呈正相关(R = 0.73±0.03,P < 0.05)。新方法能够正确估计sBRS,并揭示了先前未被认识到的sBRS快速波动的存在。

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