Montano N, Cogliati C, Porta A, Pagani M, Malliani A, Narkiewicz K, Abboud F M, Birkett C, Somers V K
Centro L.I.T.A. di Vialba, Centro Ricerche Cardiovascolari, CNR, Medicina Interna II, Ospedale "L. Sacco," Università di Milano, Italy.
Circulation. 1998 Oct 6;98(14):1394-9. doi: 10.1161/01.cir.98.14.1394.
Low-dose atropine causes bradycardia either by acting on the sinoatrial node or by its effects on central muscarinic receptors increasing vagal activity. Any central muscarinic effects of high-dose atropine on RR interval are masked by peripheral muscarinic blockade at the sinoatrial node, which causes tachycardia. Effects of central parasympathetic activation on sympathetic activity are not known.
Using power spectral analysis of RR interval, intra-arterial blood pressure, respiration, and muscle sympathetic nerve activity (MSNA), we examined the effects of both low (2 microgram/kg IV) and high (15 microgram/kg IV) doses of atropine. After low-dose atropine, RR increased by 9+/-1% (P<0.0001), the low-frequency (LF) component (in normalized units, NU) of RR variability decreased by -32+/-8%, and the high-frequency (HF)NU component increased (+74+/-19%); hence, LF/HF of RR variability fell by 52+/-10% (all P<0.01). Although overall MSNA did not change, LFNU of MSNA decreased (-15+/-5%), HFNU of MSNA increased (+31+/-3%), and LF/HF of MSNA fell (-41+/-8%) (all P<0.01). After high-dose atropine, LFNU of MSNA decreased (-17+/-12%), HFNU of MSNA increased (+22+/-3%), and LF/HF of MSNA fell (-51+/-21%) (all P<0.02).
Increasing central parasympathetic activity with low-dose atropine is associated with an increase in the HF and a decrease in the LF oscillations of both RR interval and MSNA variability. High-dose atropine similarly induces an increase in the HF and a decrease in the LF components of MSNA variability. Thus, central parasympathetic activation is able to modulate the oscillatory characteristics of sympathetic nerve traffic to peripheral blood vessels.
低剂量阿托品可通过作用于窦房结或通过其对中枢毒蕈碱受体的作用增加迷走神经活动而导致心动过缓。高剂量阿托品对RR间期的任何中枢毒蕈碱作用都被窦房结处的外周毒蕈碱阻滞所掩盖,后者会导致心动过速。中枢副交感神经激活对交感神经活动的影响尚不清楚。
我们使用RR间期、动脉内血压、呼吸和肌肉交感神经活动(MSNA)的功率谱分析,研究了低剂量(2微克/千克静脉注射)和高剂量(15微克/千克静脉注射)阿托品的作用。低剂量阿托品给药后,RR增加9±1%(P<0.0001),RR变异性的低频(LF)成分(以标准化单位,NU表示)降低-32±8%,高频(HF)NU成分增加(+74±19%);因此,RR变异性的LF/HF降低52±10%(所有P<0.01)。虽然总体MSNA没有变化,但MSNA的LFNU降低(-15±5%),MSNA的HFNU增加(+31±3%),MSNA的LF/HF降低(-41±8%)(所有P<0.01)。高剂量阿托品给药后,MSNA的LFNU降低(-17±12%),MSNA的HFNU增加(+22±3%),MSNA的LF/HF降低(-51±21%)(所有P<0.02)。
低剂量阿托品增加中枢副交感神经活动与RR间期和MSNA变异性的HF增加以及LF振荡减少有关。高剂量阿托品同样会导致MSNA变异性的HF增加和LF成分减少。因此,中枢副交感神经激活能够调节交感神经向外周血管的交通振荡特征。