Bestler M, Schandry R, Weitkunat R, Keller W, Bader A
Institut für Psychologie, Universität München.
Z Kardiol. 1989 Aug;78(8):519-25.
Passive tilt is an effective means to manipulate cardiodynamic processes. While there is a large amount of literature available concerning cardiac function with upright tilt, passive tilt into the supine position is poorly investigated. There is evidence that adapting processes to the new position do not show analogy in both conditions. In this study we investigated cardiodynamic changes occurring with passive-graded tilt from the upright position to 20 degrees headdown tilt. Twenty healthy students of both sexes participated in the study. Using impedance cardiography combined with phonocardiography it was possible to acquire stroke volume, heart rate, Heather index, and systolic time intervals. The whole procedure was repeated to test the reliability of impedance data. There was no steady augmentation of stroke volume. Between 90 degrees and 60 degrees stroke volume remained stable and showed only little change between 60 degrees and 30 degrees. Between 30 degrees and the supine position there was a steep increase of stroke volume. Tilting into the upright position apparently has a different effect. The onset of heart rate decline preceded the increase of stroke volume. It is concluded that only little changes of stroke volume/preload are necessary to induce vagal response. In the 30 degrees position both cardiac output and Heather index were minimal; this may be due to decreased sympathetic output. Systolic time intervals showed volume dependancy. Correlations between the first and second part of the study were high for all variables.
被动倾斜是操纵心脏动力学过程的一种有效手段。虽然有大量关于直立倾斜时心脏功能的文献,但被动倾斜至仰卧位的研究却很少。有证据表明,在这两种情况下,适应新姿势的过程并不相似。在本研究中,我们调查了从直立位到头向下倾斜20度的被动分级倾斜过程中发生的心脏动力学变化。20名健康的男女学生参与了这项研究。使用阻抗心动图结合心音图,可以获取每搏输出量、心率、希瑟指数和收缩期时间间期。整个过程重复进行以测试阻抗数据的可靠性。每搏输出量没有持续增加。在90度和60度之间,每搏输出量保持稳定,在60度和30度之间仅有微小变化。在30度和仰卧位之间,每搏输出量急剧增加。倾斜至直立位显然有不同的影响。心率下降先于每搏输出量增加。得出的结论是,诱导迷走神经反应仅需要每搏输出量/前负荷有微小变化。在30度位置时,心输出量和希瑟指数均最小;这可能是由于交感神经输出减少所致。收缩期时间间期显示出容量依赖性。研究的第一部分和第二部分所有变量之间的相关性都很高。