Universidad Católica del Maule, Departamento de Kinesiología, Talca, Maule, Chile.
Internal Medicine, Syncope Unit, Humanitas Clinical and Research Center- IRCCS.
J Hypertens. 2019 Aug;37(8):1714-1721. doi: 10.1097/HJH.0000000000002084.
The current study aimed to assess the effects of five cycles of automated mechanical somatosensory stimulation (AMSS) of the fore-feet on blood pressure (BP) and cardiovascular autonomic control in Parkinson's Disease patients.
Out of 23 patients, 16 underwent an AMSS session every 72 h, for a total of five sessions per patient. Electrocardiogram, noninvasive beat-to-beat blood pressure and respiratory activity were recorded for 20 min in supine position at baseline and after the AMSS sessions. Main outcomes were the changes in SBP and DBP, in the spectral indices of cardiac sympathetic (LFRRn.u.) and vagal (HFRR) modulatory activities, cardiac sympathovagal relationship (LF/HF), vascular sympathetic modulation (LFSAP) and arterial baroreflex sensitivity (sequence technique). Symbolic analysis of heart rate variability provided additional indices of cardiac sympathetic (0V%) and vagal (2UV%) modulation to the sinoatrial node.
After five AMSS trials a reduction in SBP (baseline: 131.2 ± 15.5 mmHg; post-AMSS: 122.4 ± 16.2 mmHg; P = 0.0004) and DBP (baseline: 73.2 ± 6.1 mmHg; post-AMSS: 68.9 ± 6.2 mmHg; P = 0.008) was observed. Post-AMSS, spectral and symbolic indices of cardiovascular sympathetic control decreased and arterial baroreflex sensitivity increased (baseline: 5.7 ± 1.3 ms/mmHg; post-AMSS: 11.27 ± 2.7 ms/mmHg).
AMSS sessions were effective in reducing BP, increasing baroreflex sensitivity and decreasing cardiovascular sympathetic modulation in Parkinson's disease patients. AMSS might be useful to control supine hypertension in Parkinson's disease.
本研究旨在评估五次足底自动机械感觉刺激(AMSS)对帕金森病患者血压(BP)和心血管自主控制的影响。
23 名患者中,16 名患者每 72 小时接受一次 AMSS 治疗,每位患者共接受五次治疗。在仰卧位时,记录 20 分钟的心电、无创逐搏血压和呼吸活动。在基线和 AMSS 治疗后,主要结局为 SBP 和 DBP 的变化,以及心脏交感神经(LFRRn.u.)和迷走神经(HFRR)调制活动的频谱指数、心脏交感迷走关系(LF/HF)、血管交感神经调制(LFSAP)和动脉压力反射敏感性(序列技术)。心率变异性的符号分析为窦房结提供了心脏交感神经(0V%)和迷走神经(2UV%)调制的附加指数。
五次 AMSS 试验后,SBP(基线:131.2±15.5mmHg;后 AMSS:122.4±16.2mmHg;P=0.0004)和 DBP(基线:73.2±6.1mmHg;后 AMSS:68.9±6.2mmHg;P=0.008)均降低。后 AMSS 时,心血管交感控制的频谱和符号指数降低,动脉压力反射敏感性增加(基线:5.7±1.3ms/mmHg;后 AMSS:11.27±2.7ms/mmHg)。
AMSS 治疗可有效降低帕金森病患者的血压,增加压力反射敏感性,降低心血管交感神经调节。AMSS 可能有助于控制帕金森病患者的仰卧位高血压。