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外周化学感受器失活期间呼吸和心率动力学与靶向性交感神经和交感/副交感神经(协同)激活的比较。

Respiratory and heart rate dynamics during peripheral chemoreceptor deactivation compared to targeted sympathetic and sympathetic/parasympathetic (co-)activation.

机构信息

Division of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, cNEP, cardiac Neuro- and Electrophysiology Research Consortium, Düsseldorf, Germany; General Practice for Internal Medicine "Hausärzte im Stadtzentrum", Schenefeld, Germany.

Division of Cardiology/Angiology/Intensive Care, EVK Düsseldorf, cNEP, cardiac Neuro- and Electrophysiology Research Consortium, Düsseldorf, Germany; DZHK (German Center for Cardiovascular Research), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany.

出版信息

Auton Neurosci. 2022 Sep;241:103009. doi: 10.1016/j.autneu.2022.103009. Epub 2022 Jun 15.

Abstract

BACKGROUND

The importance of peripheral chemoreceptors for cardiorespiratory neural control is known for decades. Pure oxygen inhalation deactivates chemoreceptors and increases parasympathetic outflow. However, the relationship between autonomic nervous system (ANS) activation and resulting respiratory as well as heart rate (HR) dynamics is still not fully understood.

METHODS

In young adults the impact of (1) 100 % pure oxygen inhalation (hyperoxic cardiac chemoreflex sensitivity (CHRS) testing), (2) the cold face test (CFT) and (3) the cold pressor test (CPT) on heart rate variability (HRV), hemodynamics and respiratory rate was investigated in randomized order. Baseline ANS outflow was determined assessing respiratory sinus arrhythmia via deep breathing, baroreflex sensitivity and HRV.

RESULTS

Baseline ANS outflow was normal in all participants (23 ± 1 years, 7 females, 3 males). Hyperoxic CHRS testing decreased HR (after 60 ± 3 vs before 63 ± 3 min, p = 0.004), while increasing total peripheral resistance (1053 ± 87 vs 988 ± 76 dyne*s + m/cm, p = 0.02) and mean arterial blood pressure (93 ± 4 vs 91 ± 4 mm Hg, p = 0.02). HRV indicated increased parasympathetic outflow after hyperoxic CHRS testing accompanied by a decrease in respiratory rate (15 ± 1vs 19 ± 1 min, p = 0.001). In contrast, neither CFT nor CPT altered the respiratory rate (18 ± 1 vs 18 ± 2 min, p = 0.38 and 18 ± 1 vs 18 ± 1 min, p = 0.84, respectively).

CONCLUSION

Changes in HR characteristics during deactivation of peripheral chemoreceptors but not during the CFT and CPT are related with a decrease in respiratory rate. This highlights the need of respiratory rate assessment when evaluating adaptations of cardiorespiratory chemoreceptor control.

摘要

背景

几十年来,外周化学感受器对心肺神经控制的重要性已为人所知。纯氧吸入可使化学感受器失活并增加副交感神经传出。然而,自主神经系统(ANS)激活与呼吸和心率(HR)动力学之间的关系仍不完全清楚。

方法

在年轻成年人中,以随机顺序研究了(1)100%纯氧吸入(高氧心脏化学感受器反射敏感性(CHRS)测试),(2)冷面部测试(CFT)和(3)冷加压测试(CPT)对心率变异性(HRV)、血液动力学和呼吸率的影响。通过深呼吸、压力反射敏感性和 HRV 评估,确定基线 ANS 输出。

结果

所有参与者的基线 ANS 输出均正常(23±1 岁,7 名女性,3 名男性)。高氧 CHRS 测试降低了 HR(60±3 分钟后比 63±3 分钟时,p=0.004),同时增加了总外周阻力(1053±87 与 988±76 dyne*s+m/cm,p=0.02)和平均动脉血压(93±4 与 91±4 mmHg,p=0.02)。HRV 表明高氧 CHRS 测试后副交感神经传出增加,同时呼吸率下降(15±1 与 19±1 分钟,p=0.001)。相比之下,CFT 和 CPT 均未改变呼吸率(18±1 与 18±2 分钟,p=0.38 和 18±1 与 18±1 分钟,p=0.84)。

结论

外周化学感受器失活过程中 HR 特征的变化与呼吸率下降有关,但 CFT 和 CPT 期间则没有。这突出表明,在评估心肺化学感受器控制的适应时,需要评估呼吸率。

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