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首页> 外文期刊>American Journal of Physiology >Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder
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Acute effects of device-guided slow breathing on sympathetic nerve activity and baroreflex sensitivity in posttraumatic stress disorder

机译：设备导向慢呼吸对近体应激障碍的交感神经活动和肾病敏感性的急性效应

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Patients with posttraumatic stress disorder (PTSD) have elevated sympathetic nervous system reactivity and impaired sympathetic and cardiovagal baroreflex sensitivity (BRS). Device-guided slow breathing (DGB) has been shown to lower blood pressure (BP) and sympathetic activity in other patient populations. We hypothesized that DGB acutely lowers BP, heart rate (HR), and improves BRS in PTSD. In 23 prehypertensive veterans with PTSD, we measured continuous BP, ECG, and muscle sympathetic nerve activity (MSNA) at rest and during 15 min of DGB at 5 breaths/min (n = 13) or identical sham device breathing at normal rates of 14 breaths/min (sham; n = 10). Sympathetic and cardiovagal BRS was quantified using pharmacological manipulation of BP via the modified Oxford technique at baseline and during the last 5 min of DGB or sham. There was a significant reduction in systolic BP (by ?9?±?2 mmHg, P < 0.001), diastolic BP (by ?3?±?1 mmHg, P = 0.019), mean arterial pressure (by ?4?±?1 mmHg, P = 0.002), and MSNA burst frequency (by ?7.8?±?2.1 bursts/min, P = 0.004) with DGB but no significant change in HR (P > 0.05). Within the sham group, there was no significant change in diastolic BP, mean arterial pressure, HR, or MSNA burst frequency, but there was a small but significant decrease in systolic BP (P = 0.034) and MSNA burst incidence (P = 0.033). Sympathetic BRS increased significantly in the DGB group (?1.08?±?0.25 to ?2.29?±?0.24 bursts·100 heart beats?1·mmHg?1, P?= 0.014) but decreased in the sham group (?1.58?±?0.34 to –0.82?±?0.28 bursts·100 heart beats?1·mmHg?1, P = 0.025) (time × device, P = 0.001). There was no significant difference in the change in cardiovagal BRS between the groups (time × device, P = 0.496). DGB acutely lowers BP and MSNA and improves sympathetic but not cardiovagal BRS in prehypertensive veterans with PTSD.NEW & NOTEWORTHY Posttraumatic stress disorder is characterized by augmented sympathetic reactivity, impaired baroreflex sensitivity, and an increased risk for developing hypertension and cardiovascular disease. This is the first study to examine the potential beneficial effects of device-guided slow breathing on hemodynamics, sympathetic activity, and arterial baroreflex sensitivity in prehypertensive veterans with posttraumatic stress disorder.
机译：患有错误胁迫障碍（PTSD）的患者升高了交感神经系统的反应性和交感神经和心脏心脏折射敏感性（BRS）受损。设备引导慢呼吸（DGB）已被证明降低血压（BP）和其他患者种群的交感神经活动。我们假设DGB急剧降低了BP，心率（HR），并改善了PTSD中的BRS。在23个具有PTSD的PTS型老师，我们在休息时测量连续的BP，ECG和肌肉交感神经活动（MSNA），在5次呼吸/分钟（n = 13）或相同的假目设备呼吸在14次呼吸/分钟（假; n = 10）。通过在基线的改性牛津技术和DGB或假的后5分钟内使用改性的牛津技术，使用BP的药理学操作量化同情和心脏病。收缩性BP有显着还原（通过α9？±2 mmHg，P <0.001），舒张压BP（通过？3？±1 mmHg，P = 0.019），平均动脉压（通过？4？±α？ 1 mmHg，p = 0.002）和MSNA突发频率（byα7.8？±2.1突发/分钟，p = 0.004），但HR没有显着变化（p> 0.05）。在假组合中，舒张压BP，平均动脉压，HR或MSNA爆发频率没有显着变化，但收缩性BP（P = 0.034）和MSNA爆发发病率小但显着降低（P = 0.033） 。在DGB组（？1.08？±0.25至α≤0.24爆裂·100心跳中的同情BRS显着增加（？1.08？±0.25心跳？1·mmhg？1，p？= 0.014）但在假组中减少（？1.58？± ？0.34至-0.82？±0.28突发·100心跳？1·mmhg？1，p = 0.025）（时间×设备，p = 0.001）。在组之间的心电图BRS的变化中没有显着差异（时间×设备，P = 0.496）。 DGB急性降低BP和MSNA，并改善了具有PTSD的前透视退伍军人的交感神经，而不是心脏病，并且不值得注意的前后应激障碍的特征在于增强交感神反应性，肾病敏感性受损，患高血压和心血管疾病的风险增加。这是第一研究，以研究血流动力学，交感神经活动和动脉骨折呼吸对血流动力学，交感神经活性的潜在有益效果，以及具有创伤性应激障碍的血流动力学，交感神经活动和动脉大石流敏感性。

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