Niérat Marie-Cécile, Laviolette Louis, Hudson Anna, Similowski Thomas, Sévoz-Couche Caroline
Sorbonne Universités, UPMC Universite Paris 06, INSERM, UMRS1158 "Neurophysiologie respiratoire expérimentale et clinique", Paris, France.
Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada; and.
J Appl Physiol (1985). 2017 Jul 1;123(1):205-212. doi: 10.1152/japplphysiol.00078.2017. Epub 2017 May 4.
Dyspnea is associated with an emotional reaction that involves limbic activation. The inspiratory threshold load (ITL) is known to elicit a dyspneic response in healthy subjects. Laboratory-induced stress conditions have been shown to elicit sex-related differences in cardiovascular responses. The aim of this study was to evaluate how healthy men ( = 8) and women ( = 9) react and adapt to 5-min periods of ITL at three levels (low, medium, and high) in terms of heart rate (HR), temporal (RMSSD) and spectral (LF, HF, LF/HF ratio) HRV indexes, and rating of breathing discomfort. HR increased with low, medium, and high ITL in men, whereas it increased only with high ITL in women. LF/HF ratio increased at low ITL in both men and women. Modifications appear to depend essentially on increased LF in men and on reduced HF in women. In addition, HRV modifications differ between men and women, following the order of presentation of ITLs. Our results show a continuous and sustained stress in men (increased HR, LF, and LF/HF ratio across ITL presentation) and a stress adaptation in women. Subjective responses of breathing discomfort were not correlated with sympatho-vagal balance modifications for a subgroup of subjects ( = 10). Breathing against the ITL induced autonomic modifications that are different between men and women, i.e., driven by sympathetic mediated responses in men, whereas women showed a greater parasympathetic modulation of cardiovascular activity. These results highlight the role of the mechanical inspiratory load in the heart rate variability seen in chronic obstructive pulmonary disease. Breathing against the ITL induced autonomic modifications driven by sympathetic mediated responses in men, whereas women showed a greater parasympathetic modulation of cardiovascular activity, even for low load. A stress circuit could be at the origin of autonomic modifications induced by ITL. Our results would underline the role of the mechanic inspiratory load in the abnormalities in heart rate variability seen in COPD patients.
呼吸困难与涉及边缘系统激活的情绪反应相关。已知吸气阈值负荷(ITL)会在健康受试者中引发呼吸困难反应。实验室诱导的应激条件已显示会引发心血管反应中的性别差异。本研究的目的是评估健康男性(n = 8)和女性(n = 9)在心率(HR)、时域(RMSSD)和频域(LF、HF、LF/HF比值)心率变异性(HRV)指标以及呼吸不适评分方面,如何对三个水平(低、中、高)的5分钟ITL做出反应并适应。男性的HR在低、中、高ITL时均升高,而女性仅在高ITL时升高。男性和女性在低ITL时LF/HF比值均升高。这种变化似乎主要取决于男性LF增加和女性HF降低。此外,HRV的变化在男性和女性之间有所不同,遵循ITL呈现的顺序。我们的结果显示男性存在持续且持续的应激(在整个ITL呈现过程中HR、LF和LF/HF比值增加),而女性则存在应激适应。对于一部分受试者(n = 10),呼吸不适的主观反应与交感 - 迷走平衡变化无关。对抗ITL呼吸会引发男性和女性不同的自主神经变化,即男性由交感神经介导的反应驱动,而女性对心血管活动表现出更大的副交感神经调节。这些结果突出了机械吸气负荷在慢性阻塞性肺疾病中所见心率变异性中的作用。对抗ITL呼吸会引发男性由交感神经介导的反应驱动的自主神经变化,而女性即使在低负荷时也对心血管活动表现出更大的副交感神经调节。一个应激回路可能是ITL诱导的自主神经变化的根源。我们的结果将强调机械吸气负荷在慢性阻塞性肺疾病患者心率变异性异常中的作用。