SHORT-TERM MODULATION OF AUTONOMIC FUNCTION

在过去的三年里，我一直在开发一种新的方法， 了解心血管生理学通过检查动态 参与心率、动脉血调节的变异性 压力和呼吸。 该方法适用以下基本原则： 数学和物理应用于控制系统理论领域， 电子工程学对心血管稳态的分析，以及 它代表了一个明显的分歧，从更描述性的方法， 传统上由生理学家和医生使用。 本提案中所述的研究将采用一种独特的宽带 激发技术，以前用于表征呼吸 调节人体自主神经流出，分析压力感受器反射 调节心率和动脉血压。 最显著的 该工作的特点是复杂信号的组合应用 处理技术与显微神经记录，以评估节拍， 对窦房结自主神经流出量的搏动调节， 外周血管，并获得密切的准确评估， 和压力感受器反射的开环频率响应 系统运行的平均点。 技术将是 用于评估心跳到心跳压力感受器反射和呼吸调制 正常动物和人类的自主神经功能。 该项目将 分为两部分。 在第一部分，我将获得进一步的具体培训 通过3个疗程的监测， 录音. 第一部分. 在慢性动物制备中，心脏迷走神经和交感神经 将直接测量活动以通过其评估压力反射 动脉压宽带刺激期间的频率响应 主动脉封堵器套箍。 这将与血压-心脏 速率控制环关闭，并与它打开中断 房室传导 第二部分. 在人类中，腓神经肌肉交感神经活动和心脏 将测量心率以确定闭环压力反射频率 颈动脉压力感受器的宽带刺激期间的反应， 颈部吸入室。 对这些数据的分析将主要取决于 系统识别技术，用于比较开环和闭环 第一部分压力反射控制。 第三部分. 第二部分中方案的临床研究应用可能 开始于临界高血压受试者和重度高血压受试者 稳定慢性充血性心力衰竭

During the past 3 years, I have been developing a new means of understanding cardiovascular physiology by examining the dynamic variability involved in the regulation of heart rate, arterial blood pressure and respiration. The approach applies basic principles of mathematics and physics employed in control system theory in fields such as electrical engineering to the analysis of cardiovascular homeostasis, and it represents a clear divergence from the more descriptive approach traditionally used by physiologists and physicians. The studies described in this proposal will apply a unique broad-band excitation technique, which was previously used to characterize respiratory modulation of autonomic outflow in humans, to the analysis of baroreflex regulation of heart rate and arterial blood pressure. The most notable features of the work are the combined application of sophisticated signal processing techniques with microneurographic recordings to evaluate beat- to-beat regulation of autonomic outflow to he sino-atrial node and the peripheral vasculature, and to obtain an accurate assessment of the close- and open-loop frequency response of the baroreflex during manipulations of the mean point around which the system operates. The techniques will be used to evaluate beat-to-beat baroreflex and respiratory modulation of autonomic function in normal animals and humans. The project will be divided into 2 parts. during Part I, I will gain further specific training by auditing 3 courses at measurement of percutaneous intraneural recordings. Part I. In a chronic animal preparation, cardiac vagal and sympathetic activity will be measured directly to evaluate the baroreflex by its frequency response during broad-band stimulation of arterial pressure with an aortic occluder cuff. This will be done with the blood pressure - heart rate control loop closed, and with it opened by disruption of atrioventricular conduction. Part II. In humans, peroneal nerve muscle sympathetic activity and heart rate will be measured to determine the closed-loop baroreflex frequency response during broad-band stimulation of the carotid baroreceptors with a neck suction chamber. Analysis, of this data will depend critically on the system identification techniques developed to compare open- and closed-loop baroreflex control in Part I. Part III. A clinical research application of the protocol in Part II may begin on subjects with borderline hypertension and subjects with severe stable chronic congestive heart failure.