Kallenbach J M, Webster T, Dowdeswell R, Reinach S G, Millar R N, Zwi S
Chest. 1985 May;87(5):644-8. doi: 10.1378/chest.87.5.644.
The bronchial hyperreactivity characteristic of asthma may be related to enhanced parasympathetic nervous activity. We postulated that an abnormality in the autonomic control of airway caliber might be reflected by a parallel change in the reflex control of heart rate. We examined the heart-rate variations induced by deep breathing (respiratory sinus arrhythmia), the Valsalva maneuver, and standing up from the recumbent position in asthmatic subjects and nonasthmatic control subjects. The asthmatic patients had evidence of enhanced parasympathetic neural drive to the sinoatrial node, as manifested by a significantly greater magnitude of respiratory sinus arrhythmia, than the controls (p less than 0.0005). We were unable to induce a similar change in normal subjects by resistance breathing. A statistical analysis suggested the presence of a relationship between the magnitude of respiratory sinus arrhythmia and the degree of bronchial hyperreactivity in a group of asthmatic patients. Our results support the hypothesis that enhanced parasympathetic activity is an important factor in the pathogenesis of bronchial asthma.
哮喘所特有的支气管高反应性可能与副交感神经活动增强有关。我们推测，气道口径自主控制的异常可能会通过心率反射控制的平行变化得以体现。我们检测了哮喘患者和非哮喘对照者在深呼吸（呼吸性窦性心律不齐）、瓦尔萨尔瓦动作以及从卧位起身时所诱发的心率变化。哮喘患者存在副交感神经对窦房结驱动增强的证据，表现为呼吸性窦性心律不齐的幅度明显大于对照组（p小于0.0005）。我们通过阻力呼吸无法在正常受试者中诱发类似变化。一项统计分析表明，在一组哮喘患者中，呼吸性窦性心律不齐的幅度与支气管高反应性程度之间存在关联。我们的结果支持以下假说：副交感神经活动增强是支气管哮喘发病机制中的一个重要因素。
