慢性心不全の患者における,交感性神経の活動に対する呼吸器の調節
1Second Department of Internal Medicine, The First Department of Physiology, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Circulation
|July 27, 2001
まとめ
心不全の患者は,潮の体積が減少し,交感神経の活動抑制が少なくなります. これは,肺膨張反射の障害が慢性心不全における同情興奮に寄与することを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 呼吸器生理学 呼吸器生理学について
- 神経科学は神経科学である.
背景:
- 交感刺激と呼吸器の不安定性は,慢性心不全の悪化と関連しています.
- 心不全の患者において,交感性活動の呼吸器調節を理解することは極めて重要です.
研究 の 目的:
- 心不全における呼吸パターンと交感神経の活動とのダイナミックな関係を調査する.
- 呼吸器の体積が単一の呼吸で筋肉交感神経活動 (MSNA) にどのように影響するか判断する.
主な方法:
- 記録されたMSNA,血圧,呼吸器の流れは,左心室噴出分数 ≤45%の23人の患者で記録された.
- 呼吸中のMSNAの変異を分析し,一部の患者で"神経静寂" (抑制) を特定しました.
- 制御呼吸中の指数関数フィッティングを使用して,潮体積とMSNA抑制の関係を評価しました.
主要な成果:
- 呼吸内MSNA抑制は23人の患者の11人に観察されました.
- MSNA抑制のない患者では,潮体積が著しく減少し,呼吸速度は上昇した.
- ニューラルサイレンスが欠如した患者でMSNA抑制を達成するために,より大きな潮体積が必要であり,これは弱まった交感抑制性肺膨胀反射を示しています.
結論:
- 慢性心不全における交響性興奮は,休息時の潮体積の減少と関連しています.
- 肺膨張反射の弱まった交感抑制効果は,心不全における交感過剰活性に寄与する.
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