在COVID后病情和长期心血管症状的患者中调查自主神经系统功能障碍
Fernanda Stábile da Silva1, Lívia Pimenta Bonifácio2, Fernando Bellissimo-Rodrigues2
1Department of Physiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Frontiers in medicine
|October 30, 2023
概括
后COVID-19综合征患者表现出自主功能障碍,特别是交感主导,影响心率变化和动脉压力. 自主控制在六个月内逐渐改善,功能障碍减少,对头向上倾斜测试的反应正常化.
科学领域:
- 心脏病学 心脏病学
- 自主神经科学 自主神经科学
- 传染病流行病学 传染病流行病学
背景情况:
- 后COVID-19综合征 (PCS) 经常与自主功能障碍有关,包括心动减速和体位低血压.
- 通过心率变化 (HRV) 和动脉压 (AP) 变化来研究自主神经系统 (ANS) 功能,对于理解PCS病理生理学至关重要.
研究的目的:
- 评估PCS患者的HRV和AP变化及其对头向上倾斜测试 (HUTT) 的反应.
- 在六个月的时间内评估PCS患者自主功能的时间变化.
主要方法:
- 在PCS患者和健康对照者之间比较HRV和AP可变性参数 (例如RMSSD,HF功率,符号分析模式).
- 在两组中,对HUTT期间自主反应的分析.
- 六个月后对PCS患者进行重新评估,以跟踪HRV,AP可变性和HUTT反应的变化.
主要成果:
- PCS患者表现出减弱的HRV (RMSSD,HF功率,2UV模式) 和加剧的0V AP模式,这表明交感主导.
- 在PCS患者的HUTT期间,没有观察到HRV或AP可变性参数的显著变化,这表明自主控制受损.
- 六个月后,PCS患者的HRV有所改善 (更高的HF功率,2UV模式),0V AP模式减少,HUTT反应正常化.
结论:
- PCS的特点是显著的自主功能障碍,最初的交感主导和巴罗反射敏感性受损.
- 在PCS患者中,自主功能障碍显示出随着时间的推移改善的趋势,HRV和AP可变性恢复,HUTT反应正常化.
- 这些发现突显了COVID-19长期自主后果的潜力,但也表明了恢复的能力.
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