https://scholars.lib.ntu.edu.tw/handle/123456789/536735
標題: | Tight mechanism correlation between heart rate turbulence and baroreflex sensitivity: Sequential autonomic blockade analysis | 作者: | LIAN-YU LIN LING-PING LAI JIUNN-LEE LIN Du C.-C. Shau W.-Y. Chan H.-L. Tseng Y.-Z. Stephen Huang S.K. |
公開日期: | 2002 | 出版社: | Futura Publishing Company Inc. | 卷: | 13 | 期: | 5 | 起(迄)頁: | 427-431 | 來源出版物: | Journal of Cardiovascular Electrophysiology | 摘要: | Introduction: Heart rate turbulence is a powerful de novo risk predictor for patients surviving acute myocardial infarction. However, little is known about its underlying physiologic mechanism. Methods and Results: Hypothesizing that heart rate turbulence is barorceptor reflex related, we studied heart rate and blood pressure fluctuations at rest and after systematically introduced ventricular premature beats in 16 patients without structural heart disease (10 men and 6 women; mean age 45 ± 17 years) before and after sequential sympathetic (esmolol 4-mg bolus followed by 120 μg/kg/min intravenously), parasympathetic (atropine 0.04 mg/kg intravenously), and combined autonomic blockade (esmolol plus atropine). Turbulence onset (%) and turbulence slope (msec/beat) were averaged from 10 respective ventricular premature beats. Spontaneous baroreflex sensitivity (msec/mmHg) was calculated from 5 minutes of sinus rhythm recording. The results showed that turbulence slope decreased after atropine (0.71 ± 0.50 msec/beat vs 5.17 ± 3.96 msec/beat at baseline; P < 0.01) and combined autonomic blockade (1.23 ± 1.02 msec/beat; P < 0.01) but was unchanged after esmolol (4.53 ± 3.30 msec/beat; P > 0.05). Turbulence onset increased after atropine (0.32% ± 0.35% vs -0.45 ± 0.94 at baseline; P < 0.05) and combined sympathetic and parasympathetic blockade (0.58% ± 0.86%; P < 0.05) but was unchanged after esmolol (-0.62% ± 1.33%; P > 0.05). Turbulence slope was positively correlated with baroreflex sensitivity at baseline (r = 0.78, P < 0.01) and after esmolol (r = 0.8, P < 0.01), but dissociated after atropine (r = 0.16, P > 0.05) and combined autonomic blockade (r = 0.31, P > 0.05). Turbulence onset was negatively correlated with baroreflex sensitivity at baseline (r = -0.61, P < 0.05), after esmolol (r = -0.80, P < 0.01), and after atropine (r = -0.53, P < 0.05). Conclusion: Heart rate turbulence of turbulence onset and turbulence slope is critically vagal dependent and highly correlated with spontaneous baroreflex sensitivity, which underscores its clinical importance in cardiovascular risk stratification. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0036257826&doi=10.1046%2fj.1540-8167.2002.00427.x&partnerID=40&md5=aec741df5648a3803633ea574c7f974e https://scholars.lib.ntu.edu.tw/handle/123456789/536735 |
ISSN: | 1045-3873 | DOI: | 10.1046/j.1540-8167.2002.00427.x | SDG/關鍵字: | atropine; esmolol; acute heart infarction; adult; article; blood pressure monitoring; calculation; clinical article; clinical examination; controlled study; correlation analysis; extrasystole; female; heart rate; human; male; nerve block; parasympathetic nerve; prediction; pressoreceptor reflex; priority journal; risk assessment; sinus rhythm; sympathetic blocking; vagus nerve stimulation |
顯示於: | 醫學系 |
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