Sasaki Konosuke, Haga Mayu, Endo Yoichi, Fujiwara Junko, Maruyama Ryoko
Department of Health Sciences, Tohoku University Graduate School of Medicine.
Division of Clinical Physiological Laboratory, Tohoku University Hospital.
Tohoku J Exp Med. 2017 Apr;241(4):309-318. doi: 10.1620/tjem.241.309.
Some studies have reported that recumbent position may have advantages in patients with heart disease and in pregnancy. However, it remains controversial whether recumbent position affects autonomic nervous system activity and hemodynamics in healthy adults. The aim of this study was to evaluate alterations in heart rate variability (HRV) and hemodynamics in the supine, left recumbent and right recumbent positions in healthy young adults. A total of 80 participants aged 22.8 ± 3.1 years were enrolled in this observational study. Fifty-eight volunteers (29 men and 29 women) maintained the supine position followed by the left and right recumbent positions, while electrocardiographic data were recorded for spectral analysis of HRV to assess cardiac vagal nerve and sympathetic nerve activities. The heart rate (HR) was significantly lower in the left recumbent position than in the other positions. There were no statistically significant differences in HRV among the three positions. Considering the possibility that the echographic procedure affects autonomic nervous system (ANS) activity, the other 22 participants (11 men and 11 women) underwent an echographic evaluation of hemodynamics in the heart and inferior vena cava (IVC) across the three positions. Although a low HR was also observed, there were no statistically significant differences in the IVC or the heart blood volume between the supine and the left recumbent positions. A postural change to the left recumbent position does not affect the cardiac blood circulation or ANS activity, though it does decrease HR in healthy young adults. This finding indicates that the lower HR in the left recumbent position is not attributable to the ANS activity.
一些研究报告称,卧位可能对心脏病患者和孕妇有益。然而,卧位是否会影响健康成年人的自主神经系统活动和血流动力学仍存在争议。本研究的目的是评估健康年轻成年人在仰卧位、左侧卧位和右侧卧位时心率变异性(HRV)和血流动力学的变化。共有80名年龄在22.8±3.1岁的参与者纳入了这项观察性研究。58名志愿者(29名男性和29名女性)先保持仰卧位,然后是左侧卧位和右侧卧位,同时记录心电图数据以进行HRV的频谱分析,以评估心脏迷走神经和交感神经活动。左侧卧位时的心率(HR)显著低于其他体位。三个体位之间的HRV没有统计学上的显著差异。考虑到超声检查程序可能影响自主神经系统(ANS)活动的可能性,另外22名参与者(11名男性和11名女性)在三个体位下接受了心脏和下腔静脉(IVC)血流动力学的超声评估。尽管也观察到心率较低,但仰卧位和左侧卧位之间IVC或心脏血容量没有统计学上的显著差异。对于健康年轻成年人,左侧卧位的姿势改变不会影响心脏血液循环或ANS活动,尽管它确实会降低心率。这一发现表明,左侧卧位时较低的心率并非归因于ANS活动。