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 通过动态观察了解心血管生理学 与心率、动脉血调节有关的变异性 压力和呼吸。该方法应用了以下基本原则 在控制系统理论中应用的数学和物理学，如 电子工程学用于分析心血管内稳态，以及 它与更具描述性的方法有明显的不同 传统上由生理学家和内科医生使用。 这项提案中描述的研究将应用一种独特的宽带 激发技术，它以前被用来表征呼吸道 人体自主神经流出的调制对压力感受器反射的分析 调节心率和动脉血压。最值得注意的 作品的特点是综合运用了复杂的信号 用显微神经学记录评估心跳的处理技术 自主神经流出至窦房结的搏动调节 外周血管系统，并获得一个准确的评估关闭- 和压力反射在操作期间的开环频率响应 系统围绕其运行的中间点。这些技术将是 用于评估心跳间压力感受器反射和呼吸调节 正常动物和人类的自主神经功能。该项目将是 分为两部分。在第一部分中，我将获得进一步的具体培训 经皮神经内测量3个疗程的审核 录音。 第一部分在慢性动物制剂中，心脏迷走神经和交感神经 活动将被直接测量以评估压力感受器反射 宽带刺激动脉压时的频率响应 主动脉封堵器袖带。这将通过血压-心脏来完成 码率控制环路关闭，并通过中断打开 房室传导。 第二部分.在人类中，腓神经肌肉的交感活动和心脏 将测量心率以确定闭环式压力反射频率 宽频带刺激颈动脉压力感受器时的反应 颈部吸引室。对这些数据的分析将严重依赖于 为比较开环和闭环系统而开发的系统辨识技术 第一部分压力感受器反射控制。 第三部分：第二部分中方案的临床研究应用可 从临界高血压患者和重度高血压患者开始 稳定的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.