Lindqvist A, Parviainen P, Kolari P, Tuominen J, Välimäki I, Antila K, Laitinen L A
Cardiorespiratory Research Unit, University of Turku, Finland.
Cardiovasc Res. 1989 Mar;23(3):262-72. doi: 10.1093/cvr/23.3.262.
Exaggerated cardiovascular responsiveness is common in young men and may cause non-specific symptoms and poor performance. Conventional autonomic function tests are not clinically useful. We have therefore designed a thermal entrainment method to evaluate sympathetic and parasympathetic cardiovascular function in subjects with dystonic symptoms and orthostatic intolerance. Oscillations of thermal gradient in the skin were produced by standardised periodic stimulation of the lower part of the arm with warm and cool water. Vasomotor activity of the skin induced oscillations of arterial blood pressure which were thought to be regulated by sympathetic and parasympathetic heart rate control and by oscillation of the sympathetically controlled peripheral vascular resistance. We tested the method in subjects with cardiovascular symptoms (n = 7) and controls (n = 7). At supine rest, the frequency response of the heart rate variability to the thermal stimulation at frequencies of 0.01, 0.02, 0.03 and 0.1 Hz was significantly different (p = 0.008) between symptomatic subjects and controls. The gain of the heart rate control was increased to 0.03 Hz [-1.3(SEM 0.5) dB v -3.8(0.8) dB, p = 0.068] and decreased at 0.1 Hz [-3.9(1.1) dB v -1.5(0.6) dB, p = 0.076] in the test group compared to the control group. At stimulus frequencies of less than 0.03 Hz the individual overall heart rate variability of the subjects with symptoms stayed below the mean control value, at 60(6) ms v 79(15) ms, p = 0.16. The cutaneous temperature oscillations at the site of stimulation, frequency response of the oscillations of the skin blood flow and respiration to the thermal stimulation, and mean heart rate were similar in the both groups. The results show that this thermal entrainment method quantifies the increased sympathetic and decreased parasympathetic cardiac control of subjects with dystonic symptoms.
心血管反应过度在年轻男性中很常见，可能会导致非特异性症状和身体机能不佳。传统的自主神经功能测试在临床上并无用处。因此，我们设计了一种热调节方法，以评估患有肌张力障碍症状和体位性不耐受的受试者的交感神经和副交感神经心血管功能。通过用温水和冷水对手臂下部进行标准化的周期性刺激，产生皮肤温度梯度的振荡。皮肤的血管运动活动引起动脉血压的振荡，这种振荡被认为受交感神经和副交感神经心率控制以及交感神经控制的外周血管阻力振荡的调节。我们在有心血管症状的受试者（n = 7）和对照组（n = 7）中测试了该方法。在仰卧休息时，有症状受试者和对照组之间，心率变异性对频率为0.01、0.02、0.03和0.1 Hz的热刺激的频率响应存在显著差异（p = 0.008）。与对照组相比，测试组心率控制的增益在0.03 Hz时增加[-1.3（标准误0.5）dB对-3.8（0.8）dB，p = 0.068]，在0.1 Hz时降低[-3.9（1.1）dB对-1.5（0.6）dB，p = 0.076]。在刺激频率低于0.03 Hz时，有症状受试者的个体总体心率变异性低于平均对照组值，分别为60（6）ms对79（15）ms，p = 0.16。两组在刺激部位的皮肤温度振荡、皮肤血流和呼吸振荡对热刺激的频率响应以及平均心率相似。结果表明，这种热调节方法可以量化患有肌张力障碍症状的受试者交感神经对心脏控制的增强和副交感神经对心脏控制的减弱。
