System identification of closed-loop cardiovascular control mechanisms: diabetic autonomic neuropathy.
System identification of closed-loop cardiovascular control mechanisms: diabetic autonomic neuropathy.
复制标题
闭环心血管控制机制的系统识别：糖尿病自主神经病变。
DOI：
10.1152/ajpregu.1999.276.3.r905
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Freeman,R
中科院分区：
文献类型：
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作者：
Mukkamala,R;Mathias,JM;Mullen,TJ;Cohen,RJ;Freeman,R
我们应用心血管系统识别（CSI）来表征糖尿病自主神经病变（DAN）患者的闭环心血管调节。CSI方法定量分析了无创测量的心率、动脉血压（ABP）和瞬时肺容量（ILV）中的逐搏波动，以表征四种生理耦合机制，其中两种是呼吸介导的（心率压力感受器反射和呼吸耦合，以ILV测量，心率），其中两个是机械介导的（心室收缩与ABP小波生成的耦合和呼吸与ABP的耦合）。我们研究了37名对照组和60名糖尿病受试者，他们根据标准自主神经测试分为轻度、中度或重度DAN。随着DAN严重程度的增加，神经系统介导的耦合逐渐减少，而机械介导的耦合基本上没有变化。CSI确定了最小DAN组和对照组之间的差异，这些差异基于标准自主测试无法区分。CSI可以为评估DAN提供强有力的工具。
We applied cardiovascular system identification (CSI) to characterize closed-loop cardiovascular regulation in patients with diabetic autonomic neuropathy (DAN). The CSI method quantitatively analyzes beat-to-beat fluctuations in noninvasively measured heart rate, arterial blood pressure (ABP), and instantaneous lung volume (ILV) to characterize four physiological coupling mechanisms, two of which are autonomically mediated (the heart rate baroreflex and the coupling of respiration, measured in terms of ILV, to heart rate) and two of which are mechanically mediated (the coupling of ventricular contraction to the generation of the ABP wavelet and the coupling of respiration to ABP). We studied 37 control and 60 diabetic subjects who were classified as having minimal, moderate, or severe DAN on the basis of standard autonomic tests. The autonomically mediated couplings progressively decreased with increasing severity of DAN, whereas the mechanically mediated couplings were essentially unchanged. CSI identified differences between the minimal DAN and control groups, which were indistinguishable based on the standard autonomic tests. CSI may provide a powerful tool for assessing DAN.