Model for the assessment of heart period and arterial pressure variability interactions and of respiration influences
Tóm tắt
A model which assesses the closed-loop interaction between heart period (HP) and arterial pressure (AP) variabilities and the influence of respiration on both is applied to evaluate the sources of low frequency (LF∼0·1 Hz) and high frequency (HF, respiratory rate ∼0·25 Hz) in conscious dogs (n=18) and humans (n=5). A resonance of AP closed-loop regulation is found to amplify LF oscillations. In dogs, the resonance gain increases slightly during baroreceptor unloading (mild hypotension obtained with nitroglycerine (NTG) i.v. infusion, n=8) and coronary artery occlusion ((CAO), n=6), and it is abolished by ganglionic transmission blockade ((ARF), Arfonad i.v. infusion, n=3). In humans, this gain is considerably increased by passive tilt. Different, possibly central, sources of LF oscillations are also evaluated, finding a strong rhythmic modulation of HP during CAO. At HF, a direct respiratory arrhythmia is dominant in dogs at control, while it is considerably reduced during CAO. On the contrary, in humans, a strong influence of respiration on AP is shown which induces a reflex respiratory arrhythmia. An index of the gain of baroreceptive response, αcl, was decreased by NTG and CAO, and virtually abolished by chronic arterial baroreceptive denervation (TABD, n=4) and ARF.
Tài liệu tham khảo
Akselrod, S., Gordon, D., Ubel, F. A., Shannon, D. C., Barger, A. C., andCohen, R. J. (1981): ‘Power spectrum analysis of heart rate fluctuations: a quantitative probe of beat-to-beat cardiovascular control’,Sci.,213, pp. 220–222
Akselrod, S., Gordon, D., Madwed, J. B., Snidam, N. C., Shannon, D. C., andCohen, R.J. (1985): ‘Hemodynamic regulation: investigation by spectral analysis’,Am. J. Physiol.,249, pp. H867–875
Baselli, G., Cerutti, S., Civardi, S., Liberati, D., Lombardi, F., Malliani, A., andPagani, M. (1986): ‘Spectral and cross-spectral analysis of heart rate and arterial blood pressure variability signals’,Comput. Biomed. Res.,19, pp. 520–534
Baselli, G., Cerutti, S., Civardi, S., Malliani, A., Orsi, G., Pagani, M., andRizzo, G. (1987): ‘Parameter extraction from heart rate and blood pressure variability signals in dogs for the validation of a physiological model’,Comp. Biol. Med.,18, pp. 1–6
Baselli, G., Cerutti, S., Livraghi, M., Meneghin, C. I., Pagani, M., andRimoldi, O. (1988a): ‘Causal relationship between heart rate and arterial blood pressure variability signal.’,Med. & Biol. Eng. & Comput.,26, pp. 374–378
Baselli, G., Cerutti, S., Civardi, S., Malliani, A., andPagani, M. (1988b): ‘Cardiovascular variability signals: towards the identification of a closed-loop model of the neural control mechanisms’,IEEE Trans.,BME-35, pp. 1033–1046
Burattini, R., Borgdorff, P., andWesterhof, N. (1987): ‘Dynamics of the short-term regulation of arterial pressure: frequency dependence and role of arterial compliance’,Med. & Biol. Eng. & Comput.,25, pp. 277–283
Cerutti, S., Alberti, M., Baselli, G., Rimoldi, O., Malliani, A., Merri, M., andPagani, M. (1988): ‘Automatic assessment of the interaction between respiration and heart rate variability signals’,Med. Progr. through Technol.,14, p. 19
de Boer, R. W., Karemaker, J. M., andStrackee, J. (1985): ‘Relationships between short-term blood pressure fluctuations and heart-rate variability in resting subjects’,Med. & Biol. Engin. & Comput.,23, pp. 352–364
de Boer, R. W., Karemaker, J. M., andStrackee, J. (1987): ‘Hemodynamic fluctuations and baroreflex sensitivity in humans: a beat-to-beat model’,Am. J. Physiol.,253, pp. H680-H689
Furlan, R., Guzzetti, S., Crivellaro, W., Tassi, S., Tinelli, M., Baselli, G., Cerutti, S., Lombardi, F., Pagani, M., andMalliani, A. (1990): ‘Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and R-R variabilities in ambulant subjects’,Circ.,81, pp. 537–547
Gnecchi-Ruscone, T., Lombardi, F., Malfatti, G., andMalliani, A. (1987): ‘Attentuation of baroreceptive mechanisms by cardiovascular sympathetic afferent fibers’,Am. J. Physiol.,253, pp. H787-H791
Guyton, A. C., andHarris, J. W. (1951): ‘Pressoreceptor-autonomic oscillation: a probable cause of vasomotor waves’,ibid.,,165, pp. 158–166
Hosomi, H., andHayashida, Y. (1984): ‘System analysis of blood pressure oscillation’, inMiyakawa, K., Polosa, C., andKoepchen, H. P. (Eds.): ‘Mechanisms of blood pressure waves’ (Japan Sc. Soc. Press, Tokyo, Springer-Verlag, Berlin) pp. 215–227
Hyndman, B. W., Kitney, R. I., andSayers, B. McA., (1974): ‘Spontaneous rhythms in physiological control systems’,Nature,223, pp. 339–341
Kanoh, H. (1984): ‘Analysis by a methematical model’, inMiyakawa, K., Polosa, C., andKoepchen, H. P. (Eds.): ‘Mechanisms of blood pressure waves’, (Japan Sc. Soc. Press, Tokyo, Springer-Verlag, Berlin) pp. 241–254
Kitney, R. I., Fulton, T., McDonald, P. H., andLinkens, D. A. (1985): ‘Transient interactions between blood pressure, respiration and heart rate in man’,J. Biomed. Eng.,7, pp. 217–224
Koepchen, H. P., Langhorst, P., andSeller, H. (1975): ‘The problem of identification of autonomic neurons in the lower brain stem’,Brain Res.,87, pp. 375–393
Koepchen, H. P. (1984): ‘History of studies and concepts of blood pressure waves’, inMiyakawa, K., Polosa, C., andKoepchen, H. P. (Eds.), ‘Mechanisms of blood pressure waves’ (Japan Sc. Soc. Press, Tokyo, Springer-Verlag, Berlin) pp. 3–23
Lombardi, F., Sandrone, G., Perpuner, S., Sala, R., Garimoldi, M., Cerutti, S., Baselli, G., Pagani, M., andMalliani, A. (1987): ‘Heart rate variability as an index of sympatho-vagal interaction after acute myocardial infarction’,Am. J. Cardiol.,60, pp. 1239–1245
Madwed, J. B., Albrecht, P., Mark, R. G., andCohen, R. J. (1989): ‘Low-frequency oscillations in arterial pressure and heart rate: a simple computer model’,Am. J. Physiol.,256, pp. H1573-H1579
Malliani, A., Pagani, M., andLombardi, F. (1986): ‘Positive feedback reflexes’, inZanchetti, A andTarazzi, R. C. (Eds.): ‘Handbook of hypertension, Vol. 8, pathophysiology of hypertension’, (Elsevier Science Publishers) pp. 69–81
Mayer, S. (1876): ‘Uber spontane Blutdruckshwankungen’,Sber. Akad. Wiss. Wien.,74, p. 281
Pagani, M., Mirsky, I., Baig, H., Manders, W. T., Kerkhof, P., andVatner, S. F. (1979): ‘Effects of age on aortic pressure-diameter and elastic stiffness-stress relationships in unanesthetized sheep’,Circ. Res.,44, pp. 420–429
Pagani, M., Lombardi, F., Guzzetti, S., Sandrone, G., Rimoldi, O., Malfatto, G., Cerutti, S., andMalliani, A. (1984): ‘Power spectral density of heart rate variability as an index of sympatho-vagal interaction in normal and hyperntensive subjects’,J. Hypertens.,2, pp. 383–385
Pagani, M., Lombardi, F., Guzetti, S., Rimoldi, O., Furlan, R., Pizzinelli, P., Sandrone, G., Dell’Orto, S., Piccalunga, E., Turiel, M., Baselli, G., Cerutti, S., andMalliani, A. (1986): ‘Power spectral analysis of heart rate and arterial pressure variability as a marker of sympatho-vagal interaction in man and in conscious dog’,Circ. Res.,59, pp. 178–193
Pagani, M. V., Somers, V., Furlan, R., Dell’Orto, S., Conway, J., Baselli, G., Cerutti, S., Sleight, P., andMalliani, A. (1988): ‘Changes in autonomic regulation induced by physical training in mild hypertension’,Hypertens.,12, pp. 600–610
Pomeranz, B., Macaulay, R. J. B., Caudill, M. A., Kutz, I., Adam, D., Gordon, D., Kilborn, K. M., Barger, A. C., Shannon, D. C., Cohen, R. J., andBenson, H. (1985): ‘Assessment of autonomic function in humans by heart rate spectral analysis’,Am. J. Physiol.,248, pp. H151-H153
Priess, G., andPolosa, C. (1974): ‘Pattern of sympathetic neuron activity associated with Mayer waves’,Am. J. Physiol. 226, pp. 724–730
Rimoldi, O., Pierini, S., Ferrari, A., Cerutti, S., Pagani, M., andMalliani, A. (1990): ‘Analysis of the short-term oscillations of RR and arterial pressure in conscious dogs’ibid,,258, pp. H967-H976
Robbe, H., Mulder, L., Ruddel, H., Langewitz, W., Veldman, J., andMulder, G. (1987): ‘Assessment of baroceptor reflex sensitivity by means of spectral analysis’,Hypertens.,10, pp. 538–543
Sagawa, K. (1983): ‘Baroreflex control of systemic arterial pressure and vascular bed’, inShepperd, J. T., Abboud, F. M., andGeiger, S. R., (Eds.): ‘Handbook of physiology, Section 2, The cardiovascular system, Vol. III, Peripheral circulation and organ blood flow’, (American Physiological Society, Washington DC) pp. 453–496
Saul, J. P., Berger, R. D., Chen, M. H., andCohen, R. J. (1989): ‘Transfer function analysis of autonomic regulation-II respiratory sinus arrhythmia’,Am. J. Physiol.,256, pp. H153-H161
Sayers, B. McA. (1973): ‘Analysis of heart rate variability’,Ergonom.,16, pp. 85–97
Smyth, H. S., Phil, D., Sleight, P., andPickering, G. W. (1969): ‘Reflex regulation of arterial pressure during sleep in man, a quantitative method of assessing baroreflex sensitivity’,Circ. Res.,24, pp. 109–121