AUTONOMIC PATHOPHYSIOLOGY IN HEART-FAILURE PATIENTS - SYMPATHETIC-CHOLINERGIC INTERRELATIONS
AUTONOMIC PATHOPHYSIOLOGY IN HEART-FAILURE PATIENTS - SYMPATHETIC-CHOLINERGIC INTERRELATIONS
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DOI：
10.1172/jci114580
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发表时间：
1990-05-01
影响因子：
15.9
通讯作者：
MOHANTY, PK
中科院分区：
文献类型：
--
作者：
PORTER, TR;ECKBERG, DL;MOHANTY, PK
我们进行这项研究的目的是描述和了解已知交感神经活动的心力衰竭患者的迷走神经异常。我们测量了交感神经（腓神经肌肉交感神经记录和肘前静脉血浆去甲肾上腺素水平）和迷走神经（R-R间期及其标准差）活动在8名心力衰竭患者和8名年龄匹配的健康志愿者，前和后拟副交感神经和副交感神经阻滞剂硫酸阿托品静脉注射剂量。在休息时，交感神经和副交感神经流出相关的心脏衰竭患者有高交感神经和低副交感神经流出，和健康受试者有低交感神经和高副交感神经流出。已知低剂量阿托品可增加中枢迷走-心脏运动神经元的活性，可显著增加健康受试者的R-R间期，但不改变心力衰竭患者的R-R间期。因此，我们的数据文件的相互超常交感神经和低于正常的副交感神经流出心力衰竭患者，并表明这些异常的结果，部分从中枢神经系统内的异常。
We conducted this study in an effort to characterize and understand vagal abnormalities in heart failure patients whose sympathetic activity is known. We measured sympathetic (peroneal nerve muscle sympathetic recordings and antecubital vein plasma norepinephrine levels) and vagal (R-R intervals and their standard deviations) activities in eight heart failure patients and eight age-matched healthy volunteers, before and after parasympathomimetic and parasympatholytic intravenous doses of atropine sulfate. At rest, sympathetic and parasympathetic outflows were related reciprocally: heart failure patients had high sympathetic and low parasympathetic outflows, and healthy subjects had low sympathetic and high parasympathetic outflows. Low dose atropine, which is known to increase the activity of central vagal-cardiac motoneurons, significantly increased R-R intervals in healthy subjects, but did not alter R-R intervals in heart failure patients. Thus, our data document reciprocal supranormal sympathetic and subnormal parasympathetic outflows in heart failure patients and suggest that these abnormalities result in part from abnormalities within the central nervous system.