ANALYSIS OF HEART RATE VARIABILITY

已经确定，正常和 伴随着自主神经活动的变化， 紧张 系统 这可能是重要的，因为自主功能可能是 能量代谢改变的效应臂， 体重与诱导体重改变后的"正常"体重 体重减轻或增加。 我们采用药理学研究， 心脏功能的自主控制作为一般自主神经功能的估计 活动 具体来说，患者的心脏周期性是在 在心脏选择性β-1肾上腺素能阻滞剂和毒蕈碱 胆碱能阻滞，以获得交感神经控制的估计值， 副交感神经控制 同时，心率谱分析 变异性是作为这些参数的进一步估计， 确定封锁的充分性。 已经有可能表明，不仅自主神经系统的变化， 功能时，通常的体重是不同的，但肥胖的人在他们的通常 肥胖者的体重与非肥胖者不同。 肥胖者往往有 副交感神经控制较低，交感神经控制较高。 我们认为 这使得自主神经的原发性缺陷 系统是导致肥胖的原因。 更有可能的是， 发现的只是那些发生时，脂肪量增加或减少 通过实验手段。 我们建议利用这些评估自主神经功能的技术， 对体重反应的研究不仅是由热量的改变引起的， 也通过药物的管理，这反过来又影响能量， 新陈代谢. 肥胖者自主神经功能的改变程度 在通常重量下状态也将被评估为可以变化的测量 不同的遗传因素在肥胖症的发病机制中起重要作用。 随着人类肥胖的分子遗传学被更好地理解， 将评估出现的亚型的自主功能。

It has been established that alterations in body weight both in normal and in obese subjects are accompanied by changes in activity of the autonomic nervous system. This may be important since autonomic function may be an effector arm of alterations in energy metabolism which tend to restore body weight to the "usual" weight after alterations in weight by induced weight loss or weight gain. We employ pharmacological studies of the autonomic control of cardiac function as an estimate of general autonomic activity. Specifically, patients' heart periodicity was measured before and after cardio-selective beta-1 adrenergic blockade and muscarinic cholinergic blockade to obtain estimates of sympathetic control and parasympathetic control. Simultaneously, spectral analysis of heart rate variability is done as a further estimate of these parameters and also to determine the adequacy of blockade. It has been possible to show that there are not only changes in autonomic function when usual weight is varied, but obese individuals at their usual obese weight are different from the non-obese. The obese tend to have lower parasympathetic control and higher sympathetic control. We believe that this makes it unlikely that a primary defect in the autonomic nervous system is responsible for obesity. More likely, the autonomic changes found are simply those that occur when fat mass is increased or decreased by experimental means. We propose to utilize these techniques of evaluating autonomic function in studies of weight response induced not only by caloric alterations but also by the administration of drugs which, in turn, affect energy also metabolism. The degree of alteration in autonomic function in the obese state at usual weight will also be evaluated as a measure which may vary with different genetic factors important in the pathogenesis of obesity. As the molecular genetics of human obesity is better understood, each of the subtypes that emerge will be evaluated for autonomic function.