通过心率和血压变异性结合阻抗心动图评估姿势倾斜期间的血流动力学调节。

Hemodynamic regulation during postural tilt assessed by heart rate- and blood-pressure variability combined with impedance cardiography.

作者信息

Tank J, Baevsky R M, Weck M

机构信息

Clinic Bavaria Kreischa, Germany.

出版信息

Wien Med Wochenschr. 1995;145(22):616-25.

DOI:
PMID:8585217
Abstract

Assessment of heart rate and heart rate variability (HRV) are used in sports medicine and space medicine to give conclusions about the functional state of the autonomic nervous system. Furthermore, reduced HRV and changed blood pressure variability (BPV) are accepted as risk factors in patients with cardiovascular diseases, metabolic syndrome and neurologic disorders. The aim of the first studies was to combine the evaluation of central hemodynamic (impedance cardiography) with HRV and BPV evaluation in the time and frequency domain (fft tracking) based on a standardized clinical test with automated protocol output. Data acquisition and -analysis was realized beat to beat (Kohto Ltd., Moscow) during forced breathing (150 s, 6 breath/min) and postural tilt (7 min, supine, transition to 55 degrees in 4 s, 7 min upright) allowing one to evaluate: orthostatic response type including impedance cardiography; activation of vagal afferences and efferences by forced breathing; vagal and sympathetic components during initial heart rate and blood pressure responses; characteristic changes of spectral balance of HRV and BPV (measured at the finger) during early regulation. First investigations on 34 normal volunteers subdivided into two age groups and on 13 patients with different diseases indicate that besides the age dependent changes (reduced HRV, reduced cardiac performance, reduced regulatory amplitudes and baroreflex sensitivity) individual response types can be described and dysfunction of different reflex loops can be detected. Consequently, the assessment of specific influences onto circulatory control by therapy, sport and rehabilitative training is possible and further studies are necessary.

摘要

在运动医学和航天医学中,心率及心率变异性(HRV)评估用于得出自主神经系统功能状态的结论。此外,心率变异性降低和血压变异性(BPV)改变被视为心血管疾病、代谢综合征和神经系统疾病患者的风险因素。最初研究的目的是基于具有自动协议输出的标准化临床试验,将中心血流动力学评估(阻抗心动图)与心率变异性和血压变异性的时域和频域(快速傅里叶变换跟踪)评估相结合。在强制呼吸(150秒,每分钟6次呼吸)和体位倾斜(7分钟,仰卧位,4秒内转为55度,7分钟直立位)过程中逐搏进行数据采集和分析(莫斯科科托有限公司),从而能够评估:包括阻抗心动图在内的直立反应类型;强制呼吸对迷走神经传入和传出的激活;初始心率和血压反应期间的迷走神经和交感神经成分;早期调节期间心率变异性和血压变异性(在手指处测量)频谱平衡的特征变化。对34名正常志愿者(分为两个年龄组)和13名患有不同疾病的患者进行的初步研究表明,除了年龄依赖性变化(心率变异性降低、心脏功能降低、调节幅度降低和压力反射敏感性降低)外,还可以描述个体反应类型,并检测不同反射环的功能障碍。因此,评估治疗、运动和康复训练对循环控制的特定影响是可能的,进一步的研究是必要的。

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