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体位改变时心脏压力反射带宽的变化。

Changes of the cardiac baroreflex bandwidth during postural challenges.

作者信息

Porta Alberto, Gelpi Francesca, Bari Vlasta, Cairo Beatrice, De Maria Beatrice, Takahashi Anielle C M, Catai Aparecida M, Colombo Riccardo

机构信息

Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.

Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, Milan, Italy.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2023 Apr 1;324(4):R601-R612. doi: 10.1152/ajpregu.00305.2022. Epub 2023 Mar 6.

Abstract

Baroreflex is commonly typified from heart period (HP) and systolic arterial pressure (SAP) spontaneous variations in the frequency domain mainly by estimating its sensitivity. However, an informative parameter linked to the rapidity of the HP response to SAP changes, such as the baroreflex bandwidth, remains unquantified. We propose a model-based parametric approach for estimating the baroreflex bandwidth from the impulse response function (IRF) of the HP-SAP transfer function (TF). The approach accounts explicitly for the action of mechanisms modifying HP regardless of SAP changes. The method was tested during graded baroreceptor unloading induced by head-up tilt (HUT) at 15°, 30°, 45°, 60°, and 75° (T15, T30, T45, T60, and T75) in 17 healthy individuals (age: 21-36 yr; 9 females and 8 males) and during baroreceptor loading obtained via head-down tilt (HDT) at -25° in 13 healthy men (age: 41-71 yr). The bandwidth was estimated as the decay constant of the monoexponential IRF fitting. The method was robust because the monoexponential fitting described adequately the HP dynamics following an impulse of SAP. We observed that ) baroreflex bandwidth is reduced during graded HUT and this narrowing is accompanied by the reduction of the bandwidth of mechanisms that modify HP regardless of SAP changes and ) baroreflex bandwidth is not affected by HDT but that of SAP-unrelated mechanisms becomes wider. This study provides a method for estimating a baroreflex feature that provides different information compared with the more usual baroreflex sensitivity while accounting explicitly for the action of mechanisms changing HP irrespective of SAP.

摘要

压力反射通常通过估计其敏感性,主要从心率(HP)和收缩期动脉压(SAP)在频域中的自发变化来表征。然而,一个与HP对SAP变化的快速反应相关的信息性参数,如压力反射带宽,仍未得到量化。我们提出了一种基于模型的参数化方法,用于从HP-SAP传递函数(TF)的脉冲响应函数(IRF)估计压力反射带宽。该方法明确考虑了无论SAP变化如何,改变HP的机制的作用。在17名健康个体(年龄:21 - 36岁;9名女性和8名男性)中,通过15°、30°、45°、60°和75°(T15、T30、T45、T60和T75)的头高位倾斜(HUT)诱导分级压力感受器卸载期间,以及在13名健康男性(年龄:41 - 71岁)中通过-25°的头低位倾斜(HDT)获得压力感受器加载期间,对该方法进行了测试。带宽被估计为单指数IRF拟合的衰减常数。该方法具有鲁棒性,因为单指数拟合充分描述了SAP脉冲后的HP动态。我们观察到:1)在分级HUT期间压力反射带宽降低,并且这种变窄伴随着无论SAP变化如何改变HP的机制的带宽降低;2)压力反射带宽不受HDT影响,但与SAP无关的机制的带宽变宽。本研究提供了一种估计压力反射特征的方法,该方法与更常用的压力反射敏感性相比提供了不同的信息,同时明确考虑了无论SAP如何改变HP的机制的作用。

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