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以心率和血压为重点的心血管参数变异性的生理学及临床意义

Physiology and clinical implications of variability of cardiovascular parameters with focus on heart rate and blood pressure.

作者信息

Malliani A, Pagani M, Lombardi F

机构信息

Ospedale L. Sacco, Milano, Italy.

出版信息

Am J Cardiol. 1994 Apr 7;73(10):3C-9C. doi: 10.1016/0002-9149(94)90617-3.

DOI:10.1016/0002-9149(94)90617-3
PMID:8166052
Abstract

Power spectral analysis of heart period (R-R) and arterial pressure short-term variability reveals the existence of two rhythmic oscillations: a high frequency (HF) component corresponding to respiratory activity (around 0.25 Hz) and a low frequency (LF) component corresponding to vasomotor waves (around 0.10 Hz). Further, a very low frequency (VLF) component, with a center frequency around 0 Hz, can be identified. It is generally accepted that the power of the HF component of R-R variability is a marker of vagal activity to the sinoatrial node. We have introduced the hypothesis, which is becoming progressively accepted, that the LF component of R-R variability is a marker of sympathetic modulation of the sinoatrial node, whereas the LF component of arterial pressure variability is a marker of sympathetic modulation of vasomotor tone. Moreover, we have suggested that the evaluation (in normalized units) of the LF and HF components of R-R variability (or the LF/HF ratio) can assess the state of the sympatho-vagal balance modulating the sino-atrial node in numerous physiologic and physiopathologic conditions. A large body of evidence has been gathered on the basis of multiple recordings of cardiovascular signals obtained in humans and in acute and chronic animal experiments in favor of this hypothesis.

摘要

心动周期(R-R)和动脉压短期变异性的功率谱分析揭示了两种节律性振荡的存在:一种高频(HF)成分对应于呼吸活动(约0.25Hz),一种低频(LF)成分对应于血管舒缩波(约0.10Hz)。此外,还可识别出一种中心频率约为0Hz的极低频(VLF)成分。一般认为,R-R变异性的HF成分功率是迷走神经对窦房结活动的一个标志。我们提出的假说正逐渐被接受,即R-R变异性的LF成分是交感神经对窦房结调节的一个标志,而动脉压变异性的LF成分是交感神经对血管舒缩张力调节的一个标志。此外,我们还提出,对R-R变异性的LF和HF成分进行评估(以标准化单位表示)(或LF/HF比值),可以在多种生理和病理生理条件下评估调节窦房结的交感-迷走平衡状态。基于在人类以及急性和慢性动物实验中获得的心血管信号的多次记录,已经收集了大量证据支持这一假说。

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