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慢性疼痛中的血流动力学:通往多模式健康风险的途径。

Hemodynamics in chronic pain: A pathway to multi-modal health risks.

作者信息

Davydov Dmitry M, Galvez-Sánchez Carmen M, Reyes Del Paso Gustavo A

机构信息

María Zambrano senior scholar, University of Jaén, Jaén, Spain.

Department of Personality, Evaluation and Psychological Treatment, University of Murcia, Murcia, Spain.

出版信息

PLoS One. 2024 Dec 10;19(12):e0315341. doi: 10.1371/journal.pone.0315341. eCollection 2024.

Abstract

Pain-o-metry provides biomarkers indicating connections between pain-related conditions and the health of various physiological systems, including the cardiovascular system. In this study, a non-linear data-driven analytical technique was employed to analyze second-by-second hemodynamic responses to recurrent clino-orthostatic challenges in 43 female fibromyalgia patients and 38 healthy women. The primary goal was to elucidate the systemic and systematic interaction of diverse hemodynamic and cardiovascular mechanisms across various timeframes and phases, precisely identifying their collective role as a unified bodily mechanism in managing regular gravity-induced blood redistribution challenges within the context of chronic pain. Findings suggest a connection between chronic disease and the equilibrium between cardiac preload and afterload in blood pressure regulation. Patients exhibit a shift towards afterload due to deficiencies in mechanisms governing initial transient reactions and later steady-state processes related to acutely induced blood redistributions. The imbalance is linked to reduced venous blood return, increasing cardiac strain-particularly in terms of contractility and heart rate-as the body compensates for heightened cardiac afterload and reduced effective blood volume. This makes individuals more susceptible to chronic peripheral tissue and cerebrovascular hypoperfusion, potentially leading to chronic ischemia and inflammation in various tissues and organs. The data-driven analytical technique enables the identification of combinations of gravity-induced hemodynamic and cardiovascular responses within specific timeframes for precise detection. This approach aims to facilitate potential diagnostic and monitoring applications in wearable devices, enhancing the ability to identify at-risk populations for preventive interventions.

摘要

疼痛测量法可提供生物标志物,表明疼痛相关病症与包括心血管系统在内的各种生理系统健康之间的联系。在本研究中,采用了一种非线性数据驱动分析技术,来分析43名女性纤维肌痛患者和38名健康女性对反复进行的临床直立位挑战的逐秒血流动力学反应。主要目标是阐明不同血流动力学和心血管机制在不同时间框架和阶段的系统性和整体性相互作用,精确确定它们作为统一身体机制在慢性疼痛背景下应对常规重力诱导的血液重新分布挑战中的共同作用。研究结果表明慢性病与血压调节中心脏前负荷和后负荷之间的平衡存在关联。由于在控制与急性诱导的血液重新分布相关的初始瞬态反应和后期稳态过程的机制方面存在缺陷,患者表现出向后负荷的转变。这种失衡与静脉血回流减少有关,随着身体补偿增加的心脏后负荷和减少的有效血容量,心脏应变增加,特别是在收缩性和心率方面。这使得个体更容易受到慢性外周组织和脑血管灌注不足的影响,可能导致各种组织和器官的慢性缺血和炎症。数据驱动分析技术能够识别特定时间框架内重力诱导的血流动力学和心血管反应的组合,以进行精确检测。这种方法旨在促进可穿戴设备中的潜在诊断和监测应用,提高识别高危人群以进行预防性干预的能力。

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