健康なヒトにおける偶発的な血管関節反応に先立つ心臓の自律的なパターン
R Furlan1, S Piazza, S Dell'Orto
1Centro Ricerche Cardiovascolari, CNR; Medicina Interna II e Medicina Interna III, Università di Milano, Italy.
Circulation
|October 27, 1998
まとめ
オーソスタティック・ヴァソヴァガル・シンコペは,2つの異なる心臓の自律的なパターンを伴う:一つは,交感性の活性が増加し,もう一つは,交感性の抑制とヴァガル・ドミナンスである. これらのパターンを理解することは,治療戦略を助けます.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の研究
- 生理学 生理学とは
背景:
- オーソスタティック・ヴァソヴァガル・シンコペは,様々な臨床症状を呈し,多種多様な心臓の自律的調節を示す.
- 心拍数の神経制御を理解することは,の診断に不可欠です.
研究 の 目的:
- 心臓の神経制御におけるビート・バイ・ビートの変化を,昏睡期前の心臓の神経制御を調査する.
- ヴァソヴァガル・シンコープに先立つ自律的調節パターンを区別するために.
主な方法:
- RR間隔の変動を時間変数パワースペクトル解析を用いて,頭から上へと傾ける時のシンコープ患者22名と対照群22名で分析した.
- 低周波 (LF) と高周波 (HF) の正常化された電力 (NU) を通してRRの変動性を評価した交感性および静脈変調.
主要な成果:
- 座っている状態での血液動力学またはスペクトルパラメータでは,グループ間の有意な差異はありません.
- シンコープ患者は,早期の傾き中にRRの間隔が短縮されたことを示しました.
- 2つの異なるパターンが出現した:13人の患者はLF/HFが増加した (交感的優位性),9人はLF/HFが減少し,シンコープ前にHFが増加した (陰道的優位性).
結論:
- 静脈管内麻痺の前には2つの異なる心臓の自律的なパターンがあります: 漸進的な交感性活性化または交感性阻害で静脈管が優位です.
- これらの独特な病理生理学的メカニズムを特定することで,昏睡の標的治療の介入に情報を与えることができます.
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