Associations between the Autonomic Nervous System and the Second Derivative of the Finger Photoplethysmogram Indices
Associations between the Autonomic Nervous System and the Second Derivative of the Finger Photoplethysmogram Indices
复制标题
DOI：
10.5551/jat.19877
复制
发表时间：
2014-01-01
影响因子：
4.4
通讯作者：
Sugiyama, Kazuna
中科院分区：
文献类型：
--
作者：
Kohjitani, Atsushi;Miyata, Masaaki;Sugiyama, Kazuna
目的：手指光电容积图二阶导数（SDPTG）的指标反映了大动脉僵硬度、外周血管阻力和血管老化。然而，自主神经活动和SDPTG指数之间的关联尚未阐明。方法：SDPTG和心率变异性（HRV）连续测量在坐位手术前一天在168例18-89岁。分析SDPTG指标（B/a、c/a、d/a和e/a）与HRV指标（功率谱分析和时域分析参数）之间的关系。结果：SDPTG指数B/a与低频（LF）（R=-0.44和0.42）和高频（HF）（R =-0.31和0.35）呈负相关，d/a指数与LF（R=-0.44和0.42）和HF（R=-0.31和0.35）呈正相关。SDPTG指数c/a也与LF（R=0.40）和HF（R=0.44）成分呈正相关。多因素回归分析显示LF、HF和心率是影响c/a的独立因素。此外，高血压、糖尿病和高脂血症患者的c/a值显著低于无这些疾病的患者，且c/a降低与血清甘油三酯和总胆固醇浓度升高显著相关。这些结果表明，c/A与外周血管活性的压力反射反应降低和心脏副交感神经活性降低有关。此外，发现c/a的降低与动脉粥样硬化相关，如高血压、糖尿病和高脂血症。
Aim: The indices of the second derivative of the finger photoplethysmogram (SDPTG) denote stiffness of large arteries, peripheral vascular resistance and vascular aging. However, the association between the autonomic nervous activity and the SDPTG indices has not yet been elucidated.Methods: The SDPTG and heart rate variability (HRV) were consecutively measured in the sitting position on the day before surgery in 168 patients 18-89 years of age. The relationships between the SDPTG indices (b/a, c/a, d/a and e/a) and HRV indices (power spectral analysis and time domain analysis parameters) were analyzed. The relationships between c/a and atherosclerosis-based conditions and risk factors for atherosclerosis were also evaluated.Results: The SDPTG index b/a was negatively associated and the d/a index was positively associated with the low-frequency (LF) (R=-0.44 and 0.42, respectively) and high-frequency (HF) components (R=-0.31 and 0.35, respectively). The SDPTG index c/a was also positively associated with the LF (R=0.40) and HF (R=0.44) components. A multivariate regression analysis showed that the LF, HF and heart rate were independent determinants of the c/a. Furthermore, the c/a values were significantly lower in the patients with hypertension, diabetes mellitus and hyperlipidemia than in those without these diseases, and a reduced c/a was significantly associated with increased serum triglyceride and total cholesterol concentrations.Conclusions: These findings suggest that a decrease in c/a is associated with a reduced baroreflex response of the peripheral vasomotor activity and a decreased cardiac parasympathetic activity. Furthermore, a decrease in c/a was found to be associated with atherosclerosis-based conditions, such as hypertension, diabetes mellitus and hyperlipidemia.