Piepoli M, Sleight P, Leuzzi S, Valle F, Spadacini G, Passino C, Johnston J, Bernardi L
Department of Cardiovascular Medicine, John Radcliffe Hospital, University of Oxford, UK.
Circulation. 1997 Apr 1;95(7):1813-21. doi: 10.1161/01.cir.95.7.1813.
We investigated whether respiratory sinus arrhythmia (RSA) in healthy humans originated from central neuronal oscillations or from peripheral baroreceptors responding to respiratory changes in venous return.
During subjects' controlled breathing we used sinusoidal neck suction to influence RSA (spectral analysis of RR interval). In 11 subjects, 20-second apnea greatly reduced RSA, which was restored by neck suction at the frequency of respiration. Counteracting the respiration-induced cycles of carotid blood pressure decreased RSA in 13 subjects (from 2136 +/- 682 to 1372 +/- 561 ms2, P < .01). The critical phase of this neck suction was constant for each subject at around the phase shift (with regard to respiration-related fluctuations of blood pressure) best for smoothing respiratory (mechanical) changes in blood pressure. Suction of a non-baroreceptor area (the thigh) did not affect RSA. In 4 subjects, to separate the effects of peripheral baroreceptor afferents from respiration-entrained central oscillation (15 breaths/min), we cycled the neck suction at 12 cycles/min. Increasing neck suction from -7 to -30 mm Hg increased the ratio of the power of the 12 cycles compared with the 15-cycle RSA oscillation in RR interval spectral analysis from 0.26 to 2.57. A 12-cycle/min suction of an area other than the neck had little effect on the RR interval spectrum.
RSA can be mimicked or reduced by stimulation of arterial baroreceptors with cycles of appropriately phased neck suction at the frequency of respiration. This suggests an important influence of the arterial baroreceptors in the generation of RSA in conscious humans.
我们研究了健康人的呼吸性窦性心律不齐(RSA)是源于中枢神经元振荡还是源于外周压力感受器对静脉回流呼吸变化的反应。
在受试者进行控制性呼吸期间,我们使用正弦颈部吸引来影响RSA(RR间期的频谱分析)。在11名受试者中,20秒的呼吸暂停使RSA大幅降低,通过以呼吸频率进行颈部吸引可使其恢复。抵消呼吸引起的颈动脉血压周期变化可使13名受试者的RSA降低(从2136±682降至1372±561 ms2,P<.01)。对于每个受试者,这种颈部吸引的关键相位在相位偏移(相对于与呼吸相关的血压波动)周围是恒定的,最有利于平滑血压的呼吸(机械)变化。对非压力感受器区域(大腿)进行吸引不影响RSA。在4名受试者中,为了区分外周压力感受器传入神经与呼吸夹带的中枢振荡(15次/分钟)的影响,我们以12次/分钟的频率循环进行颈部吸引。在RR间期频谱分析中,将颈部吸引从-7 mmHg增加到-30 mmHg,使12次循环的功率与15次循环的RSA振荡功率之比从0.26增加到2.57。以12次/分钟的频率对颈部以外的区域进行吸引对RR间期频谱影响很小。
通过以呼吸频率进行适当相位的颈部吸引循环刺激动脉压力感受器,可以模拟或降低RSA。这表明动脉压力感受器在清醒人类RSA的产生中具有重要影响。