Effects of exercise training on arterial-cardiac baroreflex function in POTS
Effects of exercise training on arterial-cardiac baroreflex function in POTS
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DOI：
10.1007/s10286-010-0091-5
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发表时间：
2011-04-01
影响因子：
5.8
通讯作者：
Levine, Benjamin D.
中科院分区：
文献类型：
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作者：
Galbreath, M. Melyn;Shibata, Shigeki;Levine, Benjamin D.
体位性直立性心动过速综合征(POTS)的特征是直立位过度心动过速。为了验证POTS患者的动脉-心脏压力反射功能受损的假设，而运动训练使这些患者的压力反射功能正常化。17名POTS患者接受了为期3个月的运动训练，年龄27+/-A9(平均+/-ASD)。通过训练前后仰卧位和60A直立位自主呼吸时搏动R-R间期(RRI)和收缩压(SBP)变异性的频谱和传递函数分析来评价动脉-心脏压力感受器反射功能。将数据与17名健康久坐的对照组进行比较。尽管患者的直立心率(HR)高于对照组，但RRI变异性指数在不同组之间没有差异。作为动脉-心脏压力反射敏感性指标的传递函数增益(SBP-RRI)在低频(LF，P=0.470)和高频(HF，P=0.663)范围内与对照组相似。在POTS患者中，短期运动训练降低了直立心率，增加了RRI变异性。在这些患者中，仰卧位和直立倾斜时的LF压力反射增益显著增加[方差分析，P=0.105]，而HF增益在训练后轻度增加(方差分析，P=0.105)，但与健康对照组相比，压力反射增益仍保持在正常范围内。短期运动训练增加了这些患者的压力反射敏感性，并伴随着直立心率的下降。
Postural orthostatic tachycardia syndrome (POTS) is characterized by excessive tachycardia in the upright position. To test the hypothesis that patients with POTS have impaired arterial-cardiac baroreflex function, while exercise training normalizes the baroreflex function in these patients.Seventeen POTS patients aged 27 +/- A 9 (mean +/- A SD) years underwent an exercise training program for 3 months. Arterial-cardiac baroreflex function was assessed by spectral and transfer function analysis of beat-to-beat R-R interval (RRI) and systolic blood pressure (SBP) variability in the supine position and at 60A degrees upright tilt during spontaneous breathing before and after training. Data were compared with 17 healthy sedentary controls.Even though upright heart rate (HR) was greater in patients than controls, indexes of RRI variability did not differ between groups. Transfer function gain (SBP to RRI), used as an index of arterial-cardiac baroreflex sensitivity was similar between patients and controls in both low- (LF, P = 0.470) and high-frequency (HF, P = 0.663) ranges. Short-term exercise training decreased upright HR and increased RRI variability in POTS patients. LF baroreflex gain increased significantly in the supine position and during upright tilt [analysis of variance (ANOVA), P = 0.04 for training], while HF gain increased modestly after training (ANOVA, P = 0.105 for training) in these patients; however, the baroreflex gains remained within the normal ranges when compared with healthy controls.These data suggest that patients with POTS have normal arterial-cardiac baroreflex function in both supine and upright postures. Short-term exercise training increases the baroreflex sensitivity in these patients, associated with a decrease in upright heart rate.