Impaired heart rate responses to cough and deep breathing in elderly patients with unexplained syncope.
Impaired heart rate responses to cough and deep breathing in elderly patients with unexplained syncope.
复制标题
患有不明原因晕厥的老年患者对咳嗽和深呼吸的心率反应受损。
DOI：
10.1016/0002-9149(87)90621-7
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
Mark,R
中科院分区：
文献类型：
--
作者：
Maddens,M;Lipsitz,LA;Wei,JY;Pluchino,FC;Mark,R
为了验证老年不明原因晕厥患者自主心率控制功能受损的假设，我们研究了12例老年患者（85±4岁）、14例老年对照（82±7岁）和10例年轻受试者（26±5岁）对深呼吸和咳嗽的变时性反应。老年晕厥患者的静息RR间期与对照组无差异。然而，患者深呼吸时最大RR/最小RR（心率变异性指数）的比值显著低于对照组（p < 0.005）。在咳嗽后1分钟内，初始反射性心动过速无差异，但随后的反跳性心动过缓在老年晕厥患者中减弱。老年不明原因晕厥患者的主要损害是对深呼吸和咳嗽反应的心动过缓，提示这些患者可能有副交感神经调节心率受损。虽然不太可能是这些患者晕厥的原因，但这些发现可能反映了潜在的自主神经缺陷。
To test the hypothesis that elderly patients with unexplained syncope have impaired autonomie control of heart rate, chronotropic responses to deep breathing and cough were studied in 12 elderly patients (85 ± 4 years), 14 elderly control subjects (82 ± 7 years) and 10 young subjects (26 ± 5 years). There was no difference in resting RR interval between elderly patients with syncope and control subjects. However, the ratio of the maximum RR/minimum RR (an index of heart rate variability) during deep breathing was significantly lower in patients than in control subjects (p < 0.005). In the minute following cough, there was no difference in initial reflex tachycardia, but subsequent rebound bradycardia was blunted in the elderly patients with syncope. The predominant impairment in elderly patients with unexplained syncope was the bradycardia component of the responses to deep breathing and cough, suggesting that these patients may have impaired parasympathetic modulation of heart rate. Although not likely to be the cause of syncope in these patients, these findings may reflect an underlying autonomic defect.