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中枢性血容量减少对交感神经刺激的心血管反应模式

Cardiovascular Response Patterns to Sympathetic Stimulation by Central Hypovolemia.

作者信息

Bronzwaer Anne-Sophie G T, Verbree Jasper, Stok Wim J, van Buchem Mark A, Daemen Mat J A P, van Osch Matthias J P, van Lieshout Johannes J

机构信息

Department of Internal Medicine, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands; Laboratory for Clinical Cardiovascular Physiology, Center for Heart Failure Research, Academic Medical CenterAmsterdam, Netherlands.

Department of Radiology, Leiden University Medical Center Leiden, Netherlands.

出版信息

Front Physiol. 2016 Jun 20;7:235. doi: 10.3389/fphys.2016.00235. eCollection 2016.

Abstract

In healthy subjects, variation in cardiovascular responses to sympathetic stimulation evoked by submaximal lower body negative pressure (LBNP) is considerable. This study addressed the question whether inter-subject variation in cardiovascular responses coincides with consistent and reproducible responses in an individual subject. In 10 healthy subjects (5 female, median age 22 years), continuous hemodynamic parameters (finger plethysmography; Nexfin, Edwards Lifesciences), and time-domain baroreflex sensitivity (BRS) were quantified during three consecutive 5-min runs of LBNP at -50 mmHg. The protocol was repeated after 1 week to establish intra-subject reproducibility. In response to LBNP, 5 subjects (3 females) showed a prominent increase in heart rate (HR; 54 ± 14%, p = 0.001) with no change in total peripheral resistance (TPR; p = 0.25) whereas the other 5 subjects (2 females) demonstrated a significant rise in TPR (7 ± 3%, p = 0.017) with a moderate increase in HR (21 ± 9%, p = 0.004). These different reflex responses coincided with differences in resting BRS (22 ± 8 vs. 11 ± 3 ms/mmHg, p = 0.049) and resting HR (57 ± 8 vs. 71 ± 12 bpm, p = 0.047) and were highly reproducible over time. In conclusion, we found distinct cardiovascular response patterns to sympathetic stimulation by LBNP in young healthy individuals. These patterns of preferential autonomic blood pressure control appeared related to resting cardiac BRS and HR and were consistent over time.

摘要

在健康受试者中,次最大程度的下体负压(LBNP)诱发的交感神经刺激所引起的心血管反应存在相当大的个体差异。本研究探讨了受试者间心血管反应的差异是否与个体受试者一致且可重复的反应相吻合。在10名健康受试者(5名女性,中位年龄22岁)中,在连续三次-50 mmHg的5分钟LBNP过程中,对连续的血流动力学参数(手指体积描记法;Nexfin,爱德华生命科学公司)和时域压力反射敏感性(BRS)进行了量化。1周后重复该方案以确定受试者内的可重复性。对LBNP的反应中,5名受试者(3名女性)心率(HR)显著增加(54±14%,p = 0.001),总外周阻力(TPR)无变化(p = 0.25),而另外5名受试者(2名女性)TPR显著升高(7±3%,p = 0.017),HR中度增加(21±9%,p = 0.004)。这些不同的反射反应与静息BRS(22±8 vs. 11±3 ms/mmHg,p = 0.049)和静息HR(57±8 vs. 71±12 bpm,p = 0.047)的差异一致,并且随时间具有高度可重复性。总之,我们在年轻健康个体中发现了对LBNP交感神经刺激的不同心血管反应模式。这些优先自主血压控制模式似乎与静息心脏BRS和HR有关,并且随时间一致。

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