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首页> 美国卫生研究院文献>American Journal of Physiology - Heart and Circulatory Physiology >Effect of autonomic blocking agents on the respiratory-related oscillations of ventricular action potential duration in humans
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Effect of autonomic blocking agents on the respiratory-related oscillations of ventricular action potential duration in humans

机译：自主神经阻滞剂对人心室动作电位持续时间与呼吸有关的振荡的影响

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Ventricular action potential duration (APD) is an important component of many physiological functions including arrhythmogenesis. APD oscillations have recently been reported in humans at the respiratory frequency. This study investigates the contribution of the autonomic nervous system to these oscillations. In 10 patients undergoing treatment for supraventricular arrhythmias, activation recovery intervals (ARI; a conventional surrogate for APD) were measured from multiple left and right ventricular (RV) endocardial sites, together with femoral artery pressure. Respiration was voluntarily regulated and heart rate clamped by RV pacing. Sympathetic and parasympathetic blockade was achieved using intravenous metoprolol and atropine, respectively. Metroprolol reduced the rate of pressure development (maximal change in pressure over time): 1,271 (± 646) vs. 930 (± 433) mmHg/s; P < 0.01. Systolic blood pressure (SBP) showed a trend to decrease after metoprolol, 133 (± 21) vs. 128 (± 25) mmHg; P = 0.06, and atropine infusion, 122 (± 26) mmHg; P < 0.05. ARI and SBP exhibited significant cyclical variations (P < 0.05) with respiration in all subjects with peak-to-peak amplitudes ranging between 0.7 and 17.0 mmHg and 1 and 16 ms, respectively. Infusion of metoprolol reduced the mean peak-to-peak amplitude [ARI, 6.2 (± 1.4) vs. 4.4 (± 1.0) ms, P = 0.008; SBP, 8.4 (± 1.6) vs. 6.2 (± 2.0) mmHg, P = 0.002]. The addition of atropine had no significant effect. ARI, SBP, and respiration showed significant coupling (P < 0.05) at the breathing frequency in all subjects. Directed coherence from respiration to ARI was high and reduced after metoprolol infusion [0.70 (± 0.17) vs. 0.50 (± 0.23); P < 0.05]. These results suggest a role of respiration in modulating the electrophysiology of ventricular myocardium in humans, which is partly, but not totally, mediated by β-adrenergic mechanisms.
机译：心室动作电位持续时间（APD）是许多生理功能（包括心律失常）的重要组成部分。最近在人类中以呼吸频率报道了APD振荡。这项研究调查了自主神经系统对这些振荡的贡献。在接受室上性心律失常治疗的10例患者中，从多个左心室和右心室（RV）心内膜部位以及股动脉压测量了激活恢复间隔（ARI； APD的常规替代药物）。自愿调节呼吸，并通过RV起搏控制心率。分别使用静脉美托洛尔和阿托品实现了交感和副交感神经阻滞。 Metroprolol降低了压力发展的速度（压力随时间的最大变化）：1,271（±646）vs. 930（±433）mmHg / s； P ＜0.01。美托洛尔治疗后收缩压（SBP）呈下降趋势，分别为133（±21）mmHg和128（±25）mmHg。 P = 0.06，阿托品输注量为122（±26）mmHg； P ＜0.05。 ARI和SBP在所有受试者中均表现出明显的呼吸周期性变化（P <0.05），其峰峰幅度分别在0.7和17.0 mmHg之间以及1和16 ms之间。输注美托洛尔降低了平均峰峰幅度[ARI，6.2（±1.4）vs. 4.4（±1.0）ms，P = 0.008； SBP为8.4（±1.6）mmHg，6.2（±2.0）mmHg，P = 0.002]。阿托品的添加没有明显的作用。在所有受试者中，ARI，SBP和呼吸在呼吸频率上显示出显着的耦合（P <0.05）。美托洛尔输注后，从呼吸到ARI的直接相关性很高，并且降低了[0.70（±0.17）对0.50（±0.23）； P ＜0.05]。这些结果表明呼吸作用在调节人的心室心肌的电生理中的作用，这部分但不是全部地由β-肾上腺素能机制介导。

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