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健康个体中热环境与主动站立测试对心血管自主控制的相互作用。

The interplay between heated environment and active standing test on cardiovascular autonomic control in healthy individuals.

机构信息

Laboratory of Experimental and Applied Exercise Physiology, Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.

Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, I-20122 Milan, Italy.

出版信息

Physiol Meas. 2021 Aug 27;42(8). doi: 10.1088/1361-6579/ac1497.

Abstract

To investigate the interplay between active standing and heat stress on cardiovascular autonomic modulation in healthy individuals.Blood pressure (BP) and ECG were continuously recorded during 30 min in supine (SUP) and 6 min in orthostatic position (ORT) under thermal reference (TC; ∼24 °C) or heated environment (HOT; ∼36 °C) conditions, in a randomized order. All data collection was performed during the winter and spring seasons when typical outdoor temperatures are ∼23 °C. Spectral analysis was employed by the autoregressive model of R-R and systolic blood pressure (SBP) time series and defined, within each band, in low (LF, 0.04 to 0.15 Hz) and high (0.15-0.40 Hz) frequencies. The indices of cardiac sympathetic (LF) and cardiac parasympathetic (HF) were normalized (nu) dividing each band power by the total power subtracted the very-low component (<0.04 Hz), obtaining the cardiac autonomic balance (LF/HF) modulation. The gain of the relationship between SBP and R-R variabilities within the LF band was utilized for analysis of spontaneous baroreflex sensitivity (alpha index;LF). Nonlinear analysis was employed through symbolic dynamics of R-R, which provided the percentage of sequences of three heart periods without changes in R-R interval (0V%; cardiac sympathetic modulation) and two significant variations (2UV% and 2LV%; cardiac vagal modulation).HOT increased 0V% and HR, and decreasedLF and 2UV% during SUP compared to TC. During ORT, HOT provokes a greater increment on HR, LF/HF and 0V%, indexes compared to ORT under TC.At rest, heat stress influences both autonomic branches, increasing sympathetic and decreasing vagal modulation and spontaneous baroreflex sensitivity. The augmented HR during active standing under heat stress seems to be mediated by a greater increment in cardiac sympathetic modulation, showing an interplay between gravitational and thermal stimulus.

摘要

研究健康个体主动站立和热应激对心血管自主调节的相互作用。在热参考(TC;约 24°C)或加热环境(HOT;约 36°C)条件下,以随机顺序,在仰卧位(SUP)下连续记录 30 分钟和在直立位(ORT)下记录 6 分钟期间,连续记录血压(BP)和心电图(ECG)。所有数据采集均在冬季和春季进行,此时典型的室外温度约为 23°C。通过 R-R 和收缩压(SBP)时间序列的自回归模型进行频谱分析,并在每个频段内定义低频(LF,0.04 至 0.15 Hz)和高频(0.15-0.40 Hz)频率。心脏交感神经(LF)和心脏副交感神经(HF)的指数通过将每个频段的功率除以减去非常低的组件(<0.04 Hz)的总功率进行归一化(nu),从而获得心脏自主平衡(LF/HF)调制。LF 频段内 SBP 和 R-R 变异性之间关系的增益用于分析自发性血压反射敏感性(LF 指数;alpha 指数)。通过 R-R 的符号动力学进行非线性分析,提供 R-R 间期无变化序列的百分比(0V%;心脏交感神经调制)和两个显著变化(2UV%和 2LV%;心脏迷走神经调制)。与 TC 相比,SUP 时 HOT 增加了 0V%和 HR,并降低了 LF 和 2UV%。在 ORT 期间,与 TC 下的 ORT 相比,HOT 引起 HR、LF/HF 和 0V%的增加更大。在休息时,热应激会影响自主神经的两个分支,增加交感神经和降低迷走神经调制和自发性血压反射敏感性。在热应激下主动站立时,心率的增加似乎是由于心脏交感神经调制的增加而介导的,表明重力和热刺激之间存在相互作用。

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