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[三种评估正常血压和高血压受试者心脏压力反射自发性敏感性方法的比较]

[Comparison of three methods for the estimation of spontaneous cardiac baroreflex sensitivity in normotensive and hypertensive subjects].

作者信息

Ducher M, Siché J P, Fauvel J P, Gustin M P, Pozet N, Paultre C, Cerutti C

机构信息

Département de néphrologie, hôpital E. Herriot, Lyon.

出版信息

Arch Mal Coeur Vaiss. 1995 Aug;88(8):1233-6.

PMID:8572880
Abstract

This study aimed at comparing estimations of spontaneous cardiac baroreflex sensitivity (BRS) obtained with 3 different methods from continuous non-invasive blood pressure recordings in humans. A new method, allowing the quantification of the statistical dependence between values of 2 parameters (Z coefficient), was applied to beat-to-beat systolic blood pressure (SBP) and heart period (HP) values. SBP and HP values with positive Z coefficient and corresponding to baroreflex activity (SBP and HP values both lower or higher than the modal values) were submitted to a linear regression and the regression coefficient (Zgain) was taken as an index of BRS. Second, cross-spectral analysis of SBP and HP gave a BRS value (Csgain) computed as the average value of transfer function moduli for frequencies between 0.07 and 0.14 Hz, with coherence between SBP and HP greater than 0.5. The third method relies on the analysis of linear sequences (r > 0.97) containing at least 3 values of SBP and HP varying in the same direction. The average regression coefficient obtained from all selected SBP and HP sequences is the index of BRS (Seqgain). SBP and HR were recorded during 1 hour with a Finapres in 10 healthy male volunteers (NT), 23 to 32 year-old (SBP: 123 +/- 2 mmHg) and 10 recent and untreated hypertensive subjects (HT) (SBP: 152 +/- 6 mmHg). [table: see text] These results show that, in both groups, Zgain and Seqgain correlated with Csgain. No correlation was found between Zgain and Seqgain in healthy volunteers whereas the correlation was strong in hypertensives probably due to more heterogeneous SBP levels and BRS values in these subjects. This suggests that these methods are sensitive to different ways of response of the baroreflex.

摘要

本研究旨在比较通过3种不同方法从人体连续无创血压记录中获得的自发性心脏压力反射敏感性(BRS)估计值。一种新方法,即允许对两个参数值之间的统计依赖性进行量化(Z系数),被应用于逐搏收缩压(SBP)和心动周期(HP)值。具有正Z系数且对应于压力反射活动的SBP和HP值(SBP和HP值均低于或高于模态值)进行线性回归,回归系数(Z增益)被用作BRS的指标。其次,SBP和HP的交叉谱分析给出了一个BRS值(Csgain),计算为0.07至0.14 Hz频率之间传递函数模量的平均值,SBP和HP之间的相干性大于0.5。第三种方法依赖于对包含至少3个同向变化的SBP和HP值的线性序列(r>0.97)进行分析。从所有选定的SBP和HP序列获得的平均回归系数是BRS的指标(Seqgain)。使用Finapres在10名健康男性志愿者(NT)中记录SBP和HR 1小时(年龄23至32岁,SBP:123±2 mmHg)以及10名近期未治疗的高血压受试者(HT)(SBP:152±6 mmHg)。[表格:见原文]这些结果表明,在两组中,Z增益和Seq增益与Csgain相关。在健康志愿者中未发现Z增益和Seq增益之间的相关性,而在高血压患者中相关性很强,这可能是由于这些受试者的SBP水平和BRS值更具异质性。这表明这些方法对压力反射的不同反应方式敏感。

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