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中心动脉顺应性对脑血管血流动力学的影响:耐力训练干预的见解

The influence of central arterial compliance on cerebrovascular hemodynamics: insights from endurance training intervention.

作者信息

Tomoto Tsubasa, Sugawara Jun, Nogami Yoshie, Aonuma Kazutaka, Maeda Seiji

机构信息

Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan; Human Informatics Research Institute, National Institute of Advance Industrial Science and Technology, Tsukuba Japan;

Human Informatics Research Institute, National Institute of Advance Industrial Science and Technology, Tsukuba Japan;

出版信息

J Appl Physiol (1985). 2015 Sep 1;119(5):445-51. doi: 10.1152/japplphysiol.00129.2015. Epub 2015 Jul 2.

Abstract

Normally, central elastic arteries (e.g., aorta and common carotid artery) effectively buffer cardiac pulsation-induced flow/pressure fluctuations. With advancing age, arterial stiffening deteriorates this function and produces the greater cerebral hemodynamic pulsatility that impacts vulnerable brain tissue. It is well known that the buffering function of the central artery is improved by regular aerobic exercise, but the influence of endurance training on the pulsatile component of cerebral hemodynamics remains poorly understood. To characterize the functional role of the central artery at the heart-brain hemodynamic connection comprehensively, we assessed relations among the endurance training-induced changes in the left ventricle (LV), carotid arterial compliance, and cerebral hemodynamics. Thirteen collegiate tennis players (20 ± 1 yr) underwent a 16-wk endurance training intervention designed for improving cardiovascular function. Expectedly, maximal oxygen uptake (V̇o2peak), LV ejection velocity (via Doppler ultrasound), and the maximal rate of pressure increase of estimated aortic pressure waveform (via general transfer function) improved after the training intervention, whereas middle cerebral arterial (MCA) hemodynamics (via transcranial Doppler), such as mean and pulsatile flow velocities, remained unchanged. Carotid arterial compliance (via ultrasound and applanation tonometry) increased after the training intervention, and a larger increase in carotid arterial compliance was significantly associated with the greater attenuations of pulsatile MCA velocity (r = -0.621) normalized by mean MCA velocity. These results suggest that the training-induced improvement of carotid artery Windkessel function might offset the expected increase in the pulsatile component of cerebral perfusion induced by the enhanced LV systolic function.

摘要

正常情况下,中枢弹性动脉(如主动脉和颈总动脉)可有效缓冲心脏搏动引起的血流/压力波动。随着年龄增长,动脉僵硬会使这种功能恶化,并产生更大的脑血流动力学搏动,从而影响脆弱的脑组织。众所周知,规律的有氧运动可改善中枢动脉的缓冲功能,但耐力训练对脑血流动力学搏动成分的影响仍知之甚少。为全面表征中枢动脉在心脏-脑血流动力学连接中的功能作用,我们评估了耐力训练引起的左心室(LV)变化、颈动脉顺应性和脑血流动力学之间的关系。13名大学网球运动员(20±1岁)接受了为期16周的旨在改善心血管功能的耐力训练干预。不出所料,训练干预后,最大摄氧量(V̇o2peak)、左心室射血速度(通过多普勒超声)以及估计主动脉压力波形的最大压力上升速率(通过通用传递函数)均有所改善,而大脑中动脉(MCA)血流动力学(通过经颅多普勒),如平均和搏动血流速度,保持不变。训练干预后颈动脉顺应性(通过超声和压平眼压计)增加,且颈动脉顺应性的更大增加与搏动性MCA速度(通过平均MCA速度归一化)的更大衰减显著相关(r = -0.621)。这些结果表明,训练引起的颈动脉风箱功能改善可能抵消了因左心室收缩功能增强而导致的脑灌注搏动成分预期增加。

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