Galletly D C, Larsen P D
Section of Anaesthesia, Wellington School of Medicine, New Zealand.
Br J Anaesth. 1998 Feb;80(2):164-8. doi: 10.1093/bja/80.2.164.
Recent studies have suggested a role for respiratory sinus arrhythmia in improving pulmonary gas transfer. However, the physiological role of cardioventilatory coupling is unknown. We have tested the hypothesis that cardioventilatory coupling aligns heart beats at positions of the ventilatory cycle where they are maximally affected by respiratory sinus arrhythmia (RSA). In 15 anaesthetized, spontaneously breathing subjects, we recorded continuously the timing of inspiration and the ECG. We then plotted the change in RR interval which occurred, as a result of RSA, after onset of inspiration (RSA plot). By comparing these RSA plots with the distribution of heart beats during the ventilatory cycle, we were able to examine the positioning of heart beats relative to acceleration of heart rate as a result of RSA. In all but two subjects we observed that during periods of strong cardioventilatory coupling, heart beats occurred at positions in the ventilatory cycle where they were maximally affected by RSA. In the presence of strong coupling, the shortest possible RR interval occurred during late inspiration, the longest possible RR interval occurred immediately before the start of inspiration. We suggest that cardioventilatory coupling may have a physiological role in optimizing RSA, perhaps to improve cardiopulmonary performance during sleep.
近期研究表明呼吸性窦性心律不齐在改善肺气体交换方面发挥着作用。然而，心肺耦合的生理作用尚不清楚。我们检验了这样一个假设：心肺耦合会使心跳与呼吸周期中受呼吸性窦性心律不齐（RSA）影响最大的位置对齐。在15名麻醉状态下自主呼吸的受试者中，我们持续记录吸气时间和心电图。然后我们绘制了吸气开始后由于RSA导致的RR间期变化图（RSA图）。通过将这些RSA图与呼吸周期中心跳的分布进行比较，我们能够研究心跳相对于因RSA导致的心率加速的位置。除两名受试者外，在所有受试者中我们观察到，在心肺强耦合期间，心跳发生在呼吸周期中受RSA影响最大的位置。在强耦合存在的情况下，最短的RR间期出现在吸气后期，最长的RR间期出现在吸气开始前。我们认为心肺耦合可能在优化RSA方面具有生理作用，或许是为了改善睡眠期间的心肺功能。
