動的行動と子宮外心房ペースメーカーの自律的調節
H V Huikuri1, A M Poutiainen, T H Mäkikallio
1University of Oulu, Department of Medicine, Division of Cardiology, Oulu, Finland. heikki.huikuri@oulu.fi
Circulation
|September 29, 1999
まとめ
心拍の変動性分析は,子宮の外側心房発心や鼻節リズムにおける同様の長期的な自律的調節を示しています. しかし,短期的な心拍数ダイナミクスは,子宮外の心拍動脈ではよりランダムになります.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の規制について
- 心臓電気生理学 心臓電気生理学
背景:
- 心拍数 (HR) の変動は,通常,シヌスノードの神経調節を反映しています.
- 異常な心房焦点の自律的調節はあまり理解されていない.
- この研究では,子宮の外側心房急拍におけるHRの変動性と,副鼻腔節律を比較した.
研究 の 目的:
- 子宮の外側心房低心率,鼻腔高心率,および正常な鼻腔リズム間のHR変動を比較する.
- 異常な心房焦点の自律神経調節を調査する.
- 異なる心拍動脈における短期および長期のR-R区間の動態を特徴づける.
主な方法:
- エクトピック心房外拍動脈,副鼻腔動脈動脈,正常な副鼻腔リズムを持つ患者の24時間のホルター記録を分析した.
- 利用された時間および周波数領域HRの変動度量.
- 推定エントロピー,フラクタルスケーリング指数 (alpha{1},alpha{2}),および力法則スケーリング (β) を評価した.
主要な成果:
- 時間と周波数領域のHRの変動度測定は,子宮の外心と鼻腔タヒカルディアの間で異なるものではありませんでした.
- フラクタルスケーリング指数と近似エントロピーは,副鼻動脈と正常な副鼻律で類似していました.
- 短期スケーリング指数アルファ (((1) は,子宮外心房不動脈において有意に低く,よりランダムなR-R区間ダイナミクスを示した.
結論:
- 長期の自律的調節は,子宮の外側心房焦点とシヌスノードに類似しているようです.
- 短期的なR-R区間ダイナミクスは,子宮外タヒカルディアのランダム性の増加を示しています.
- この短期的な行動の変化は,自律的障害や内在的なペースメーカーの異常に起因する可能性があります.
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