Ørsted Nanna, Ballegaard Søren, Kristiansen Jesper, Gyntelberg Finn, Hjalmarson Ake, Faber Jens
Department of Chemistry, Technical University of Denmark, Kongens Lyngby, Denmark.
Ballegaard Ltd. Copenhagen, Skodsborg, Denmark.
Front Neurosci. 2025 May 21;19:1574942. doi: 10.3389/fnins.2025.1574942. eCollection 2025.
In 177 patients with ischemic heart disease and elevated periosteal pain sensitivity of the chest bone indicative of autonomic nervous system dysfunction, we test the hypotheses, (i) there is an association between the tilt table responses for the baroreflex-mediated cardiovascular response heart rate variability and periosteal pain sensitivity of the chest bone, (ii) these responses are affected differently by use of beta blockade medication, and (iii) reduction of an elevated periosteal pain sensitivity of the chest bone, during three months of non-pharmacological intervention, improves these responses to tilt table testing.
Baroreflex-mediated cardiovascular response, heart rate variability and periosteal pain sensitivity measures all changed significantly in response to tilt table test but only periosteal pain sensitivity and baroreflex-mediated cardiovascular responses were internally associated. Use of beta blockade medication inhibited the baroreflex-mediated cardiovascular response and heart rate variability responses but did not of periosteal pain sensitivity. In response to three months intervention with the aim to reduce the elevated periosteal pressure pain, all responses to tilt table test improved, but for the baroreflex-mediated cardiovascular response and heart variability in non-users of beta blockade, only. Participants who achieved a predefined minimum reduction of 15 units in periosteal pain sensitivity demonstrated significant improvement when compared to participants did not obtain this reduction.
Periosteal pressure sensitivity of the chest bone at rest as well as the response to tilt table test seem new and promising measures of autonomic nervous system dysfunction, which remains unaffected by BB medication.
在177例患有缺血性心脏病且胸骨骨膜疼痛敏感性升高提示自主神经系统功能障碍的患者中，我们检验以下假设：（i）压力反射介导的心血管反应心率变异性的倾斜台反应与胸骨骨膜疼痛敏感性之间存在关联；（ii）这些反应受β受体阻滞剂药物使用的影响不同；（iii）在三个月的非药物干预期间，降低升高的胸骨骨膜疼痛敏感性可改善这些对倾斜台测试的反应。
压力反射介导的心血管反应、心率变异性和骨膜疼痛敏感性指标在倾斜台测试后均有显著变化，但只有骨膜疼痛敏感性和压力反射介导的心血管反应存在内在关联。使用β受体阻滞剂药物可抑制压力反射介导的心血管反应和心率变异性反应，但对骨膜疼痛敏感性无影响。针对降低升高的骨膜压力疼痛进行三个月的干预后，所有对倾斜台测试的反应均有所改善，但仅在未使用β受体阻滞剂的患者中，压力反射介导的心血管反应和心率变异性有所改善。与未达到预先定义的骨膜疼痛敏感性至少降低15个单位的参与者相比，达到该降低幅度的参与者有显著改善。
静息时胸骨的骨膜压力敏感性以及对倾斜台测试的反应似乎是自主神经系统功能障碍的新的且有前景的指标，且不受β受体阻滞剂药物的影响。
