Role of sympathetic nerve activity in the process of fainting.
Role of sympathetic nerve activity in the process of fainting.
复制标题
DOI：
10.3389/fphys.2014.00343
复制
发表时间：
2014
影响因子：
4
通讯作者：
Mano T
中科院分区：
文献类型：
--
作者：
Iwase S;Nishimura N;Mano T
晕厥定义为短暂性意识丧失和姿势紧张，其特征为起病快、持续时间短和自发恢复，晕厥进展过程描述为两种类型的交感神经变化。同时记录显微神经摄影记录的肌肉交感神经活动（MSNA）和连续和无创血压测量揭示了晕厥进展过程中发生的事情。对于血管迷走神经或神经介导的晕厥，晕厥发作过程中可分为三个阶段：振荡期、失衡期和灾难期。血管迷走神经性晕厥的特征是交感神经兴奋，随后通过Bezold-Jorsch反射克服迷走神经。直立性晕厥是由于对直立性刺激的反应失败或交感神经活动缺乏，随后发生液体转移和随后的低脑灌注引起的。引起直立性晕厥的代偿性衰竭有四种原因：血容量不足、下体蓄积增加、交感神经活动激活失败和交感神经血管收缩刺激引起的血管收缩失败。许多病理生理条件已被描述的角度（1）夸张的交感神经兴奋和（2）未能激活交感神经。我们的结论是，交感神经系统可以控制心血管功能，其失败的结果在晕厥;然而，通过显微神经摄影记录的MSNA获得的系统的反应将决定晕厥的发病和进展的病理生理学，解释治疗效果，可以通过这种机制的分析。
Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery, and the process of syncope progression is here described with two types of sympathetic change. Simultaneous recordings of microneurographically-recorded muscle sympathetic nerve activity (MSNA) and continuous and noninvasive blood pressure measurement has disclosed what is going on during the course of syncope progression. For vasovagal or neurally mediated syncope, three stages are identified in the course of syncope onset, oscillation, imbalance, and catastrophe phases. Vasovagal syncope is characterized by sympathoexcitation, followed by vagal overcoming via the Bezold-Jarisch reflex. Orthostatic syncope is caused by response failure or a lack of sympathetic nerve activity to the orthostatic challenge, followed by fluid shift and subsequent low cerebral perfusion. Four causes are considered for the compensatory failure that triggers orthostatic syncope: hypovolemia, increased pooling in the lower body, failure to activate sympathetic activity, and failure of vasoconstriction against sympathetic vasoconstrictive stimulation. Many pathophysiological conditions have been described from the perspectives of (1) exaggerated sympathoexcitation and (2) failure to activate the sympathetic nerve. We conclude that the sympathetic nervous system can control cardiovascular function, and its failure results in syncope; however, responses of the system obtained by microneurographically-recorded MSNA would determine the pathophysiology of the onset and progression of syncope, explaining the treatment effect that could be achieved by the analysis of this mechanism.
登录
查看更多内容
DOI：
10.1152/ajpheart.00415.2013
发表时间：
2013-10-01
影响因子：
4.8
作者：
Schwartz, Christopher E.;Lambert, Elisabeth;Stewart, Julian M.
通讯作者：
Stewart, Julian M.
影响因子：
2.7
作者：
Iwase, S;Mano, T;Suzumura, A
通讯作者：
Suzumura, A
影响因子：
39.3
作者：
Vaddadi, Gautam;Ester, Murray D.;Lambert, Elisabeth
通讯作者：
Lambert, Elisabeth
DOI：
10.1152/ajpregu.00099.2007
发表时间：
2007-08-01
影响因子：
2.8
作者：
Salo, Lauren M.;Woods, Robyn L.;McAllen, Robin M.
通讯作者：
McAllen, Robin M.
DOI：
10.1152/ajpheart.01027.2004
发表时间：
2005-10-01
影响因子：
4.8
作者：
Kamiya, A;Hayano, J;Sugimachi, M
通讯作者：
Sugimachi, M