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シュプロヴァントリキュラ・タヒカルディア中のP波のタイミングが,血動力学的および交感神経応答に与える影響
M H Hamdan1, J D Zagrodzky, R L Page
1University of Texas Southwestern Medical Center and Dallas Veterans Affairs Medical Center, Dallas, TX 75216, USA. Hamdan@ryburn.swmed.edu44195
Circulation
|January 4, 2001
まとめ
超心室性短心 (SVT) は,血液動力学に影響する. ロングRPタキカルディア (RP>PR) は,短RPタキカルディア (RP
科学分野:
- 心血管生理学 心血管の生理学
- 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:
- 心房と心室のシストールのタイミングは,上心室動脈性急性心臓発作 (SVT) 中の血液動力学に影響を与えます.
- SVT中の自律神経系反射の変化は十分に理解されていません.
研究 の 目的:
- SVTをシミュレートしたDDDペースの間の異なる心房 (AV) 間隔に対する自律神経系の反射反応を調査する.
- 様々なシミュレートされたSVT条件下で血液動力学的安定性と交感神経活動 (SNA) を評価する.
主な方法:
- 永久的なデュアルチャンバーペースメーカーを使用した11人の患者は,DDDペースを1分175拍で実施した.
- 記録された動脈血圧 (BP),中央静脈圧 (CVP),およびAV間隔で30 ms (同時),200 ms (短いRP),および110 ms (長いRP) の筋肉SNA.
主要な成果:
- すべてのペースモードでBPが低下し,CVPが上昇し,SNAが増加しました.
- ロングRPタキカルディア (110 ms AV間隔) は,他のモードと比較して,BPの減少が著しく少なく,CVPの増加が著しく少なくなりました.
- 密接に結合した静脈収縮 (30 ms AV間隔) は,ほとんどの患者において,SNAの増加を著しく増加させた.
結論:
- 長いRPの低心力症は,優れた血液動力学的安定性に関連しています.
- 長いRPの低心拍の間の同情刺激の減少は,主に動脈の気球受容体によって媒介されます.
- 軽度の心肺血管抑制作用は,長期間RPの低心率の間,血液動力学的安定性に寄与する.
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