RESPIRATORY SINUS ARRHYTHMIA IN THE DENERVATED HUMAN-HEART
RESPIRATORY SINUS ARRHYTHMIA IN THE DENERVATED HUMAN-HEART
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DOI：
10.1152/jappl.1989.67.4.1447
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发表时间：
1989-10-01
影响因子：
3.3
通讯作者：
PINSKY, MR
中科院分区：
文献类型：
--
作者：
BERNARDI, L;KELLER, F;PINSKY, MR
我们进行这项研究，以测试是否失神经支配的人类心脏有能力表现呼吸性窦性心律失常（RSA）。利用高灵敏度的光谱分析技术为了定义呼吸频率和心率周期（R-R）之间的心跳-心跳耦合，并因此定义RSA，我们比较了在定义的呼吸频率和潮气量（VT）下的模式呼吸、Valsalva和Mueller动作、单次深呼吸、在12例正常志愿者和8例心脏移植受者中观察RSA和非模式性自主呼吸的变化。正常人R-R变化与呼吸频率变化密切相关（P < 0.001），而VT变化对R-R变化影响不大。在R-R频谱上，心脏移植患者出现与呼吸同步的振荡峰。然而，呼吸放松振荡的平均幅度是正常受试者的1.7-7.9%，并且受VT变化的影响更大。Valsalva和Mueller动作引起的R-R变化分别为正常受试者的3.8%和4.9%，而单次深呼吸引起的R-R变化为正常受试者的14.3%。RSA的程度与心脏移植后的时间无关，也与患者的年龄和性别无关。因此，心脏具有与通气同步改变心率的内在能力，这与心肌壁拉伸的变化或变化率可能独立于自主神经张力改变固有心率的假设一致。
We performed this study to test whether the denervated human heart has the ability to manifest respiratory sinus arrhythmia (RSA). With the use of a highly sensitive spectral analysis technique (cross correlation) to define beat-to-beat coupling between respiratory frequency and heart rate period (R-R) and hence RSA, we compared the effects of patterned breathing at defined respiratory frequency and tidal volumes (VT), Valsalva and Mueller maneuvers, single deep breaths, and unpatterned spontaneous breathing on RSA in 12 normal volunteers and 8 cardiac allograft transplant recipients. In normal subjects R-R changes closely followed changes in respiratory frequency (P < 0.001) but were little affected by changes in VT. On the R-R spectrum, an oscillation peak synchronous with respiration was found in heart transplant patients. However, the average magnitude of the respiration-relaxed oscillations was 1.7-7.9% that seen in normal subjects and was proportionally more influenced by changes in VT. Changes in R-R induced by Valsalva and Mueller maneuvers were 3.8 and 4.9% of those seen in normal subjects, respectively, whereas changes in R-R induced by single deep breaths were 14.3% of those seen in normal subjects. The magnitude of RSA was not related to time since the heart transplantation, neither was it related to patient age or sex. Thus the heart has the intrinsic ability to vary heart rate in synchrony with ventilation, consistent with the hypothesis that changes, or rate of changes, in myocardial wall stretch might alter intrinsic heart rate independent of autonomic tone.