Periodic Breathing in Heart Failure Explained by Dynamic and Static Properties of Respiratory Control.
Periodic Breathing in Heart Failure Explained by Dynamic and Static Properties of Respiratory Control.
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DOI：
10.4137/cmc.s18761
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Sugimachi M
中科院分区：
文献类型：
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作者：
Miyamoto T;Nakahara H;Ueda S;Manabe K;Kawai E;Inagaki M;Kawada T;Sugimachi M
呼吸操作点由呼吸化学反射反馈系统内的控制器和植物子系统元件之间的相互作用确定。本研究旨在建立定量分析人体呼吸控制系统开环动力学特性的方法学基础，并应用其结果探讨慢性心力衰竭呼吸调节的详细机制和周期性呼吸的可能机制。在健康志愿者中，我们测量了动脉CO2分压（PaCO2）和每分钟通气量 以估计控制器（关系）和被控对象（关系）的动态特性。控制器和植物的动态特性近似一阶和二阶指数模型，分别，并使用参数，包括增益，时间常数，和滞后时间。然后，我们使用开环传递函数来模拟对外源性干扰的闭环呼吸响应，同时操纵参数值以偏离正常值但在生理范围内。通过增加两个子系统元件的增益的乘积（总回路增益）和滞后时间，满足系统振荡的条件（周期性呼吸的开始）。当在呼吸化学反射系统的一部分中发生异常时，控制系统的不稳定性被放大，并且可能导致呼吸异常（例如周期性呼吸）的表现。
The respiratory operating point is determined by the interplay between the controller and plant subsystem elements within the respiratory chemoreflex feedback system. This study aimed to establish the methodological basis for quantitative analysis of the open-loop dynamic properties of the human respiratory control system and to apply the results to explore detailed mechanisms of the regulation of respiration and the possible mechanism of periodic breathing in chronic heart failure. In healthy volunteers, we measured arterial CO2 partial pressure (PaCO2) and minute ventilation to estimate the dynamic properties of the controller ( relation) and plant ( relation). The dynamic properties of the controller and plant approximated first- and second-order exponential models, respectively, and were described using parameters including gain, time constant, and lag time. We then used the open-loop transfer functions to simulate the closed-loop respiratory response to an exogenous disturbance, while manipulating the parameter values to deviate from normal values but within physiological ranges. By increasing both the product of gains of the two subsystem elements (total loop gain) and the lag time, the condition of system oscillation (onset of periodic breathing) was satisfied. When abnormality occurs in a part of the respiratory chemoreflex system, instability of the control system is amplified and may result in the manifestation of respiratory abnormalities such as periodic breathing.