慢性オーソスタティック不耐性:不調和のとれた心臓および血管の交感制御による障害
1Syncope Service in the Autonomic Dysfunction Unit, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA.
Circulation
|November 17, 1998
まとめ
慢性矯正不耐症 (COI) は,若年成人において,休息時の交感活動が増加し,立ち上がる時の交感反応が低下することを意味します. しかし,バロレフレクスの機能は保たれていて,異常な交感音の分布を示唆しています.
科学分野:
- 心血管生理学 心血管の生理学
- 自律神経系の研究
- クリニカル・メディシン 臨床医学
背景:
- 慢性矯正不耐症 (COI) は,若年成人に影響を与え,自律的障害の障害として提示します.
- COIにおけるニューロ・ヒューモラルおよびヘモダイナミックパターンは,交感機能の潜在的失調および心拍数のバロレフレクスの制御を示唆する.
研究 の 目的:
- 慢性オーソスタティック不耐症の患者における交感神経系の活動とバロレフレクスの制御を調査する.
- COI患者と健康な対照群の姿勢の課題における血液動力学と神経幽默学的プロフィールを比較する.
主な方法:
- 静脈内血圧,心電図,中枢静脈圧,および休憩および傾き中の筋肉共感神経の活動を同時に記録する.
- 心拍数と血圧の変動のスペクトル分析により,交感性血管調節と交感性血管運動制御を評価する.
- 薬理学的な操作とクロススペクトル分析を使用して,バロレフレクスの感受性の評価.
主要な成果:
- COIの患者は,コントロールと比較して,より高い休息時の心拍数,筋肉の交感神経の活動,および交感血管不均衡 (LF/HF) を示した.
- 傾きの間,COIの患者は,心拍数とLF/HFのより顕著な増加を示したが,筋肉交感神経活動の鈍化した上昇を示した.
- バロレフレクスの敏感性は,静止状態のグループ間で比較可能であり,傾斜によって同様に低下しました.
結論:
- COIの特徴は,休息時のノラドレナージックトーンが上昇し,心臓の交感性過剰活動によって補償される,立ち上がる時の交感性反応が低下することです.
- COI患者では,バロレフレクスのメカニズムが機能的に保たれています.
- 心臓および血管系への中央交感性流出の異常な機能的分布は,COIの病理生理学に関係しています.
関連する概念動画
The Parasympathetic Nervous System
Overview
Disorders of the Autonomic Nervous System
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Raynaud's disease, also known as Raynaud's phenomenon, is a...
Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Angina II: Classification
Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...


