Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Division of Neuroimmunology, Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ann Clin Transl Neurol. 2023 Dec;10(12):2223-2237. doi: 10.1002/acn3.51907. Epub 2023 Sep 30.
There is a complex interaction between nervous and cardiovascular systems, but sparse data exist on brain-heart electrophysiological responses to cardiac arrest resuscitation. Our aim was to investigate dynamic changes in autonomic and cortical function during hyperacute stage post-resuscitation.
Ten rats were resuscitated from 7-min cardiac arrest, as indicators of autonomic response, heart rate (HR), and its variability (HRV) were measured. HR was monitored through continuous electrocardiography, while HRV was assessed via spectral analysis, whereby the ratio of low-/high-frequency (LF/HF) power indicates the balance between sympathetic/parasympathetic activities. Cortical response was evaluated by continuous electroencephalography and quantitative analysis. Parameters were quantified at 5-min intervals over the first-hour post-resuscitation. Neurological outcome was assessed by Neurological Deficit Score (NDS, range 0-80, higher = better outcomes) at 4-h post-resuscitation.
A significant increase in HR was noted over 15-30 min post-resuscitation (p < 0.01 vs.15-min, respectively) and correlated with higher NDS (rs = 0.56, p < 0.01). LF/HF ratio over 15-20 min was positively correlated with NDS (rs = 0.75, p < 0.05). Gamma band power surged over 15-30 min post-resuscitation (p < 0.05 vs. 0-15 min, respectively), and gamma band fraction during this period was associated with NDS (rs ≥0.70, p < 0.05, respectively). Significant correlations were identified between increased HR and gamma band power during 15-30 min (rs ≥0.83, p < 0.01, respectively) and between gamma band fraction and LF/HF ratio over 15-20 min post-resuscitation (rs = 0.85, p < 0.01).
Hyperacute recovery of autonomic and cortical function is associated with favorable functional outcomes. While this observation needs further validation, it presents a translational opportunity for better autonomic and neurologic monitoring during early periods post-resuscitation to develop novel interventions.
神经系统和心血管系统之间存在着复杂的相互作用，但关于心脏骤停复苏后脑心电生理反应的稀疏数据仍然存在。我们的目的是研究复苏后超急性期自主和皮质功能的动态变化。
10 只大鼠从 7 分钟的心脏骤停中复苏，以自主反应的指标，心率（HR）及其变异性（HRV）进行测量。通过连续心电图监测 HR，通过频谱分析评估 HRV，其中低频/高频（LF/HF）功率比表示交感/副交感活动之间的平衡。通过连续脑电图和定量分析评估皮质反应。在复苏后 1 小时内，每隔 5 分钟对参数进行量化。在复苏后 4 小时通过神经缺损评分（NDS，范围 0-80，越高越好）评估神经功能结局。
复苏后 15-30 分钟内 HR 显著增加（分别与 15 分钟相比，p<0.01），并与较高的 NDS 相关（rs=0.56，p<0.01）。LF/HF 比值在 15-20 分钟内与 NDS 呈正相关（rs=0.75，p<0.05）。在复苏后 15-30 分钟内，伽马波段功率飙升（p<0.05 与 0-15 分钟相比，分别），在此期间，伽马波段分数与 NDS 相关（rs≥0.70，p<0.05，分别）。在 15-30 分钟期间，HR 的增加与伽马波段功率之间存在显著相关性（rs≥0.83，p<0.01，分别），以及在复苏后 15-20 分钟期间，伽马波段分数与 LF/HF 比值之间存在显著相关性（rs=0.85，p<0.01）。
自主和皮质功能的超急性恢复与良好的功能结局相关。虽然这一观察结果需要进一步验证，但它为在复苏后早期更好地监测自主神经和神经系统提供了转化机会，以开发新的干预措施。
