Autonomic heart rate control at rest and during unloading of the right ventricle in repaired tetralogy of Fallot in adolescents.
Autonomic heart rate control at rest and during unloading of the right ventricle in repaired tetralogy of Fallot in adolescents.
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DOI：
10.1016/j.amjcard.2008.05.065
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发表时间：
2008-10-15
影响因子：
2.8
通讯作者：
Thaulow, Erik
中科院分区：
文献类型：
--
作者：
Wyller, Vegard Bruun;Saul, J. Philip;Barbieri, Riccardo;de Lange, Charlotte;Hopp, Einar;Norum, Ingvild B.;Thaulow, Erik
修复法洛四联症（ToF）患者的心律失常可能部分是由于右心室血流动力学改变引起的自主心率（HR）控制改变。本研究调查了ToF青少年在休息和右心室卸荷期间的自主HR控制。17例ToF患者和56例健康对照，年龄12 ~ 18岁，承受体位应激，下体负压（LBNP）为- 20 mm Hg，无创记录心率、血压和脑卒中容量。在时域和频域计算了HR变异指数。所有ToF患者还进行了心脏磁共振成像，显示肺反流和右心室扩张。静息时，与对照组相比，ToF患者迷走心率控制的HR变异性指数无显著降低。在LBNP期间，对照组的HR比ToF患者增加更多（p≤0.001）。此外，大多数HR变异性指标在对照组中下降，但在ToF患者中增加（所有变量p≤0.01或p≤0.001），表明ToF患者迷走神经激活。总之，尽管右心室血流动力学改变，但ToF修复后的青少年静息时心率控制相当正常。然而，在右心室卸荷过程中，ToF患者迷走神经HR控制增加，而对照组降低。
Arrhythmias in patients with repaired tetralogy of Fallot (ToF) might be due in part to altered autonomic heart rate (HR) control caused by altered right ventricle hemodynamics. This study investigated autonomic HR control in ToF adolescents at rest and during unloading of the right ventricle. A total of 17 ToF patients and 56 healthy controls aged 12 to 18 years underwent orthostatic stress with lower body negative pressure (LBNP) of −20 mm Hg. HR, blood pressure and stroke volume were recorded non-invasively. Indices of HR variability were computed in time and frequency domains. All ToF patients also underwent cardiac magnetic resonance imaging, demonstrating pulmonary regurgitation and right ventricular dilation. At rest, HR variability indices of vagal heart rate control were non-significantly lower in the ToF patients compared to controls. During LBNP, HR increased more in controls than ToF patients (p ≤ 0.001). Further, most HR variability indices decreased among controls, but increased among ToF patients (p ≤ 0.01 or p ≤ 0.001 for all variables), suggesting vagal activation in the ToF patients. In conclusion, adolescents after ToF repair have fairly normal HR control at rest despite altered right ventricular hemodynamics. During unloading of the right ventricle, however, vagal HR control increases in the ToF patients and decreases in the controls.
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DOI：
10.1152/ajpregu.00127.2002
发表时间：
2002-11-01
影响因子：
2.8
作者：
Barbieri, R;Triedman, JK;Saul, JP
通讯作者：
Saul, JP
DOI：
10.1152/ajpregu.2001.281.1.r213
发表时间：
2001-07-01
影响因子：
2.8
作者：
Hisdal, J;Toska, K;Walloe, L
通讯作者：
Walloe, L
影响因子：
5.7
作者：
McLeod, KA;Hillis, WS;Doig, WB
通讯作者：
Doig, WB
影响因子：
8.3
作者：
PARATI, G;CASADEI, R;MANCIA, G
通讯作者：
MANCIA, G
影响因子：
1.7
作者：
Butera, G;Bonnet, D;Villain, E
通讯作者：
Villain, E