Baroreflex sensitivity, heart rate, and blood pressure variability in hypertensive pregnancy disorders
Baroreflex sensitivity, heart rate, and blood pressure variability in hypertensive pregnancy disorders
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DOI：
10.1038/sj.jhh.1001730
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发表时间：
2004-10-01
影响因子：
2.7
通讯作者：
Walther, T
中科院分区：
文献类型：
--
作者：
Faber, R;Baumert, M;Walther, T
妊娠期高血压疾病是围产期和产妇发病率和死亡率的主要原因。心率变异性（HRV）、血压变异性（BPV）和压力反射敏感性（BRS）是人类心血管风险的相关预测因子。本研究的目的是评估不同妊娠期高血压疾病之间的HRV、BPV和BRS是否存在差异。对80例健康孕妇（对照组）、19例慢性高血压（CH）、18例妊娠高血压综合征（PIH）和44例子痫前期（PE）进行连续心率和血压记录。通过时域和频域分析、非线性动力学和BRS对数据进行评估。与健康妊娠相比，所有三组高血压疾病患者的BPV均发生显著变化，其中PE患者的变化最为明显。有趣的是，PE患者的这种增加并没有导致自发性压力反射事件的升高，而其他两个高血压组的BPV变化被压力反射参数的改变所掩盖。HRV在CH和PE中无改变，但在PIH中显著受损。我们的结论是参数的HRV，BPV，和BRS不同的各种高血压妊娠疾病。因此，妊娠期高血压的不同临床表现具有不同的病理生理、调节和代偿机制。
Hypertensive pregnancy disorders are a leading cause of perinatal and maternal morbidity and mortality. Heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) are relevant predictors of cardiovascular risk in humans. The aim of the study was to evaluate whether HRV, BPV, and BRS differ between distinct hypertensive pregnancy disorders. Continuous heart rate and blood pressure recordings were performed in 80 healthy pregnant women as controls (CON), 19 with chronic hypertension (CH), 18 with pregnancy-induced hypertension (PIH), and 44 with pre-eclampsia (PE). The data were assessed by time and frequency domain analysis, nonlinear dynamics, and BRS. BPV is markedly altered in all three groups with hypertensive disorders compared to healthy pregnancies, whereby changes were most pronounced in PE patients. Interestingly, this increase in PE patients did not lead to elevated spontaneous baroreflex events, while BPV changes in both the other hypertensive groups were paralleled by alterations in baroreflex parameters. The HRV is unaltered in CH and PE but significantly impaired in PIH. We conclude that parameters of the HRV, BPV, and BRS differ between various hypertensive pregnancy disorders. Thus, distinct clinical manifestations of hypertension in pregnancy have different pathophysiological, regulatory, and compensatory mechanisms.