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动态监测患者逐搏动脉血压与心率变异性的同步分析

Simultaneous analysis of beat by beat systemic arterial pressure and heart rate variabilities in ambulatory patients.

作者信息

Pagani M, Furlan R, Dell'Orto S, Pizzinelli P, Baselli G, Cerutti S, Lombardi F, Malliani A

机构信息

Istituto Ricerche Cardiovascolari, CNR, Milan, Italy.

出版信息

J Hypertens Suppl. 1985 Dec;3(3):S83-5.

PMID:2856788
Abstract

The analysis of power spectral density (PSD) or RR variability in the electrocardiogram (ECG) has suggested that, in the early phase of essential hypertension, sympatho-vagal interaction is characterized by a sympathetic predominance. Recently, we have developed a high fidelity, direct arterial pressure ambulatory recording system which allows a beat by beat computer analysis of arterial pressure and heart rate. A microminiature tip transducer (Millar, diameter 0.8 mm) is inserted percutaneously into the radial artery and connected to a Holter two-channel magnetic tape recorder. The tip transducer has a wide band pass (> 1 kHz), excellent stability (congruent to 2 mmHg/24 h) and does not require a perfusion line. The overall frequency response of the entire recording-reproducing system is better than 20 Hz (-3 dB). The ECG and pressure signals are analysed with automatic autoregressive modelling algorithms to provide a quantitative estimate of blood pressure and heart rate variability through the computation of the PSD. In seven hypertensive patients, systolic arterial pressure and variance were higher during the day (157 +/- 9 mmHg and 122 +/- 9 mmHg2) than during the night (122 +/- 4 mmHg and 30 +/- 3 mmHg2). The PSD of RR and of systolic arterial pressure consisted of a predominant low frequency peak (congruent to 0.09 cycles/beat) during the day, and two peaks at low and high (congruent to 0.25 cycles/beat) frequency during the night. While RR variance was similar during both day- and night-time, a predominant low frequency peak was observed during the day.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对心电图(ECG)中功率谱密度(PSD)或RR变异性的分析表明,在原发性高血压的早期阶段,交感-迷走神经相互作用的特征是交感神经占优势。最近,我们开发了一种高保真直接动脉压动态记录系统,该系统允许逐搏对动脉压和心率进行计算机分析。一个微型尖端传感器(Millar,直径0.8毫米)经皮插入桡动脉,并连接到一台Holter双通道磁带记录仪。该尖端传感器具有宽通带(>1千赫)、出色的稳定性(相当于2毫米汞柱/24小时),且不需要灌注管路。整个记录-再现系统的整体频率响应优于20赫兹(-3分贝)。通过自动自回归建模算法对ECG和压力信号进行分析,以通过计算PSD来定量估计血压和心率变异性。在7名高血压患者中,白天的收缩动脉压和方差(157±9毫米汞柱和122±9毫米汞柱²)高于夜间(122±4毫米汞柱和30±3毫米汞柱²)。RR和收缩动脉压的PSD在白天由一个占主导地位的低频峰值(相当于0.09次/搏)组成,而在夜间由低频和高频(相当于0.25次/搏)两个峰值组成。虽然RR方差在白天和夜间相似,但白天观察到一个占主导地位的低频峰值。(摘要截短于250字)

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