减慢呼吸频率对正常青年人心率变异和血压变异的影响
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摘要
目的:观察减慢呼吸频率对正常青年人心率变异和血压变异的影响。方法:选择2017年5月至2017年10月锦州医科大学经入学体检健康的60例在读硕士研究生。在预先录制好的录音带放音指导下进行16次/min、12次/min、8次/min的均匀呼吸调节,用生理记录仪同步记录呼吸、心电、血压波形。观察呼吸运动对RR间期(RRI)及血压的影响;减慢呼吸频率对RRI、血压波动幅度、呼吸峰、心率和心率变异、血压变异高频功率(HF)、低频功率(LF)、LF/HF的影响,并校正减慢呼吸频率对呼吸峰移位的影响。结果:(1)RRI、血压波动周期与呼吸周期呈同步周期性变化。(2)在各呼吸频率时,心率变异及血压变异的呼吸峰(中心频率)均与呼吸功率谱密度呼吸峰(中心频率)在同一频段。16次/min位于高频段,12次/min移至低频与高频交界处,8次/min移至低频段。(3)常规心率变异、血压变异频谱分析:随呼吸频率减慢,12次/min心率变异的LF、HF增大(P<0.05),LF/HF减小(P<0.05),血压变异的LF、HF增大(P<0.05);8次/min时心率变异和血压变异的LF、LF/HF增大(P<0.05)、HF减小(P<0.05)。(4)校正呼吸峰移位影响后呼吸频率对心率变异及血压变异频谱成分影响:与呼吸频率16次/min相比,随着呼吸频率减慢,心率变异和血压变异的HF增大,LF(心率变异8次/min)、LF/HF(除外血压变异12次/min)减小,差异均有统计学意义(P均<0.05)。结论:减慢呼吸频率可使呼吸峰左移,校正减慢呼吸频率对呼吸峰移位的影响后,减慢呼吸频率可使心率变异、血压变异的HF增大,LF/HF(除外血压变异12次/min)、心率变异LF减小,提示减慢呼吸频率可增加迷走神经兴奋,有助交感-迷走平衡移向迷走神经。
Objectives: The objective of this study was to investigate the effects of controlled slow breathing on heart rate variability(HRV) and blood pressure variability(BPV) in healthy young subjects.Methods: The study population consisted of 60 healthy postgraduate students, who began their study from May 2017 to October 2017 in Jinzhou Medical University, participants underwent three periods of controlled breathing at 8, 12 and 16 breaths/min. ECG(RR), respiratory and blood pressure signal were continuously and simultaneously recorded. In our study, the influence of the respiration on RRI(RR interval) and BP were observed. Simultaneously, we studied the effects of slow breathing rate on RRI, amplitude of blood pressure oscillation, High-frequency(HF) power, low-frequency(LF) power and LF/HF of HRV and BPV. Then we also corrected the effects of slow breathing rate on respiratory peak shifts. Results: RRI and BP cyclical change coincided with the respiratory cycle. As breathing rate reduced, amplitude of RRI and blood pressure oscillation increased, heart rate slowed(P<0.05), respiratory peak shifted towards leftwards(P<0.05). Compared to 16 breaths/min, routine spectral analysis showed increased LF and HF(P<0.05) power, deceased LF/HF(P<0.05) of HRV, increased LF, HF power(P<0.05)and LF/HF of BPV during breathing at 12 breaths/min. Increased LF power(P<0.05) and LF/HF(P<0.05), deceased HF power(P<0.05) of HRV and BPV were noticed during breathing at 8 breaths/min. As the respiratory frequency decreased, corrected spectral analysis showed increased HF power, deceased LF power and LF/HF(Significant respiratory rate effects were found in HF power, LF/HF of HRV and BPV in case of 8, 12 breaths/min and LF power of HRV in case of 8 breaths/min, P<0.05). Conclusions: Reductions of respiration rate shifted the respiratory peak leftwards. Corrected spectral analysis demonstrated that slow respiration resulted in increase in HF power and decease in LF power and LF/HF. These results demonstrated that controlled slow breathing is indeed capable of increasing vagal activities and shifting sympathetic-vagal balance towards vagal activities.
Objectives: The objective of this study was to investigate the effects of controlled slow breathing on heart rate variability(HRV) and blood pressure variability(BPV) in healthy young subjects.Methods: The study population consisted of 60 healthy postgraduate students, who began their study from May 2017 to October 2017 in Jinzhou Medical University, participants underwent three periods of controlled breathing at 8, 12 and 16 breaths/min. ECG(RR), respiratory and blood pressure signal were continuously and simultaneously recorded. In our study, the influence of the respiration on RRI(RR interval) and BP were observed. Simultaneously, we studied the effects of slow breathing rate on RRI, amplitude of blood pressure oscillation, High-frequency(HF) power, low-frequency(LF) power and LF/HF of HRV and BPV. Then we also corrected the effects of slow breathing rate on respiratory peak shifts. Results: RRI and BP cyclical change coincided with the respiratory cycle. As breathing rate reduced, amplitude of RRI and blood pressure oscillation increased, heart rate slowed(P<0.05), respiratory peak shifted towards leftwards(P<0.05). Compared to 16 breaths/min, routine spectral analysis showed increased LF and HF(P<0.05) power, deceased LF/HF(P<0.05) of HRV, increased LF, HF power(P<0.05)and LF/HF of BPV during breathing at 12 breaths/min. Increased LF power(P<0.05) and LF/HF(P<0.05), deceased HF power(P<0.05) of HRV and BPV were noticed during breathing at 8 breaths/min. As the respiratory frequency decreased, corrected spectral analysis showed increased HF power, deceased LF power and LF/HF(Significant respiratory rate effects were found in HF power, LF/HF of HRV and BPV in case of 8, 12 breaths/min and LF power of HRV in case of 8 breaths/min, P<0.05). Conclusions: Reductions of respiration rate shifted the respiratory peak leftwards. Corrected spectral analysis demonstrated that slow respiration resulted in increase in HF power and decease in LF power and LF/HF. These results demonstrated that controlled slow breathing is indeed capable of increasing vagal activities and shifting sympathetic-vagal balance towards vagal activities.
引文
[1]宋麒麟,蒋桔泉.心脏交感神经功能检测方法的评价[J].中国循环杂志,2017, 32(8):823-826. DOI:10.3969/j. issn. 1000-3614.2017. 08. 023.
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[3] Rothwell PM,Howard SC,Dolan E,et al. Effects of beta blockers and caleium-channel blockers on within-individual variability in blood pressure and risk of stroke[J]. Lancet Neurol, 2010, 9(5):469-480. DOI:10. 1016/S 1474-4422(10)70066-1.
[4] Webb AJ, Fischer U, Mehta Z, et al. Effects of antihypertensivedrug class on interindividual variation in blood pressure and risk of stroke:a systematic review and meta-analysis[J]. Lancet, 2010,375(9718):906-915. DOI:10. 1016/S0140-6736(10)60235-8.
[5] Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability,maximum systolic blood pressure,and episodic hypertension[J]. Lancet, 2010, 375(9718):895-905. DOI:10. 1016/S0140-6736(10)60308-X.
[6] Mancia G. Short-and long-term blood pressure variability:present and future[J]. Hypertension, 2012, 60(2):512-517. DOI:10. 1161/HYPERTENSIONAHA.112. 194340.
[7]陈洪波,刘仁光,沈仲元.呼吸频率和潮气量对兔心率变异的影响[J].中国心脏起搏与心电生理杂志,2011,25(3):258-262. DOI:CNKI:42-1421/R. 20110610. 1620. 019.
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[9] Guasti L, Simoni C, Mainardi L, et al. Global link between heart rate and blood pressure oscillations at rest and during mental arousal in normotensive and hypertensive subjects[J]. Auton Neurosci, 2005,120(1-2):80-87. DOI:10. 1016/j. autneu. 2005. 02. 008.
[10] Bartels MN, Jelic S, Ngai P, et al. The effect of ventilation on spectral analysis of heart rate and blood pressure variability during exercise[J]. Respir Physiol Neurobiol, 2004, 144(1):91-98. DOI:10.1016/j. resp. 2004. 08.002.
[11] Aysin B,Aysin E. Effect of respiration in heart rate variability(HRV)analysis[J]. Conf Proc IEEE Eng Med Biol Soc, 2006, 1:1776-1779.DOI:10. 1109/IEMBS. 2006. 260773.
[12] Aysin B, Colombo J, Aysin E. Comparison of HRV analysis methods during orthostatic challenge:HRV with respiration or without?[J].Conf Proc IEEE Eng Med Biol Soc, 2007, 2007:5047-5050. DOI:10.1109/IEMBS. 2007. 4353474.
[13] Yang CC, Yeh IT, Lai HY, et al. Dynamic effects of respiration on aortic blood flow and its autonomic control in rats[J]. Clin Exp Pharmacol Physiol, 2008, 35(11):1294-1300. DOI:10. 1111/j. 1440-1681.2008. 04998.x.
[14] Kardos A, Rudas L, Gingl Z, et al. The mechanism of blood pressure variability. Study in patients with fixed ventricular pacemaker rhythm[J]. Eur Heart J, 1995, 16(4):545-552.
[15] Akselrod S, Gordon D, Madwed JB, et al. Hemodynamic regulation:investigation by spectral analysis[J]. Am J Physiol, 1985, 249(4 Pt2):H867-875. DOI:10. 1152/ajpheart. 1985. 249. 4. H867.
[16] Parati G, Saul JP, Di Rienzo M, et al. Spectral analysis of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal[J]. Hypertension, 1995,25(6):1276-1286.
[17] Katona PG, Jih F. Respiratory sinus arrhythmia:noninvasive measure of parasympathetic cardiac control[J]. J Appl Physiol,1975, 39(5):801-805. DOI:10. 1152/jappl. 1975. 39. 5. 801.
[18] Alcalay M, Izraeli S, Wallach-Kapon R, et al. Paradoxical pharmacodynamic effect of atropine on parasympathetic control:a study by spectral analysis of heart rate fluctuations[J]. Clin Pharmacol Ther, 1992, 52(5):518-527.
[19] Friesner SA, Curry DM, Moddeman GR. Comparison of two painmanagement strategies during chest tube removal:relaxation exercise with opioids and opioids alone[J]. Heart Lung, 2006, 35(4):269-276.DOI:10. 1016/j. hrtlng. 2005. 10. 005.
[20] Hassett AL, Radvanski DC, Vaschillo EG, et al. A pilot study of the efficacy of heart rate variability(HRV)biofeedback in patients with fibromyalgia[J]. Appl Psychophysiol Biofeedback,2007, 32(1):1-10.DOI:10. 1007/s 10484-006-902 8-0.
[21] Chalaye P, Goffaux P, Lafrenaye S, et al. Respiratory effects on experimental heat pain and cardiac activity[J]. Pain Med, 2009,10(8):1334-1340. DOI:10. 1111/j. 1526-4637. 2009. 00681. x.
[22] Pramanik T, Pudasaini B, Prajapati R. Immediate effect of a slow pace breathing exercise Bhramari pranayama on blood pressure and heart rate[J]. Nepal Med Coll J, 2010, 12(3):154-157.
[23]何亚菲,林文华.伊伐布雷定对慢性非缺血性心力衰竭患者心率变异性的影响[J].中国循环杂志,2016, 31(11):1111-1114. DOI:10.3969/j.issn.1000-3614.2016.11.016.
[2] Mancia G, Guido G. Mechanisms and clinical implications of blood pressure variability[J]. J Cardiovasc Pharmacol, 2000, 35(7 Suppl4):S15-S19.
[3] Rothwell PM,Howard SC,Dolan E,et al. Effects of beta blockers and caleium-channel blockers on within-individual variability in blood pressure and risk of stroke[J]. Lancet Neurol, 2010, 9(5):469-480. DOI:10. 1016/S 1474-4422(10)70066-1.
[4] Webb AJ, Fischer U, Mehta Z, et al. Effects of antihypertensivedrug class on interindividual variation in blood pressure and risk of stroke:a systematic review and meta-analysis[J]. Lancet, 2010,375(9718):906-915. DOI:10. 1016/S0140-6736(10)60235-8.
[5] Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability,maximum systolic blood pressure,and episodic hypertension[J]. Lancet, 2010, 375(9718):895-905. DOI:10. 1016/S0140-6736(10)60308-X.
[6] Mancia G. Short-and long-term blood pressure variability:present and future[J]. Hypertension, 2012, 60(2):512-517. DOI:10. 1161/HYPERTENSIONAHA.112. 194340.
[7]陈洪波,刘仁光,沈仲元.呼吸频率和潮气量对兔心率变异的影响[J].中国心脏起搏与心电生理杂志,2011,25(3):258-262. DOI:CNKI:42-1421/R. 20110610. 1620. 019.
[8] Brown TE, Beightol LA, Koh J, et al. Important influence of respiration on human R-R interval power spectra is largely ignored[J]. J Appl Physiol, 1993, 75(5):2310-2317. DDI:10.1152/jappl.1993.75.5. 2310.
[9] Guasti L, Simoni C, Mainardi L, et al. Global link between heart rate and blood pressure oscillations at rest and during mental arousal in normotensive and hypertensive subjects[J]. Auton Neurosci, 2005,120(1-2):80-87. DOI:10. 1016/j. autneu. 2005. 02. 008.
[10] Bartels MN, Jelic S, Ngai P, et al. The effect of ventilation on spectral analysis of heart rate and blood pressure variability during exercise[J]. Respir Physiol Neurobiol, 2004, 144(1):91-98. DOI:10.1016/j. resp. 2004. 08.002.
[11] Aysin B,Aysin E. Effect of respiration in heart rate variability(HRV)analysis[J]. Conf Proc IEEE Eng Med Biol Soc, 2006, 1:1776-1779.DOI:10. 1109/IEMBS. 2006. 260773.
[12] Aysin B, Colombo J, Aysin E. Comparison of HRV analysis methods during orthostatic challenge:HRV with respiration or without?[J].Conf Proc IEEE Eng Med Biol Soc, 2007, 2007:5047-5050. DOI:10.1109/IEMBS. 2007. 4353474.
[13] Yang CC, Yeh IT, Lai HY, et al. Dynamic effects of respiration on aortic blood flow and its autonomic control in rats[J]. Clin Exp Pharmacol Physiol, 2008, 35(11):1294-1300. DOI:10. 1111/j. 1440-1681.2008. 04998.x.
[14] Kardos A, Rudas L, Gingl Z, et al. The mechanism of blood pressure variability. Study in patients with fixed ventricular pacemaker rhythm[J]. Eur Heart J, 1995, 16(4):545-552.
[15] Akselrod S, Gordon D, Madwed JB, et al. Hemodynamic regulation:investigation by spectral analysis[J]. Am J Physiol, 1985, 249(4 Pt2):H867-875. DOI:10. 1152/ajpheart. 1985. 249. 4. H867.
[16] Parati G, Saul JP, Di Rienzo M, et al. Spectral analysis of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal[J]. Hypertension, 1995,25(6):1276-1286.
[17] Katona PG, Jih F. Respiratory sinus arrhythmia:noninvasive measure of parasympathetic cardiac control[J]. J Appl Physiol,1975, 39(5):801-805. DOI:10. 1152/jappl. 1975. 39. 5. 801.
[18] Alcalay M, Izraeli S, Wallach-Kapon R, et al. Paradoxical pharmacodynamic effect of atropine on parasympathetic control:a study by spectral analysis of heart rate fluctuations[J]. Clin Pharmacol Ther, 1992, 52(5):518-527.
[19] Friesner SA, Curry DM, Moddeman GR. Comparison of two painmanagement strategies during chest tube removal:relaxation exercise with opioids and opioids alone[J]. Heart Lung, 2006, 35(4):269-276.DOI:10. 1016/j. hrtlng. 2005. 10. 005.
[20] Hassett AL, Radvanski DC, Vaschillo EG, et al. A pilot study of the efficacy of heart rate variability(HRV)biofeedback in patients with fibromyalgia[J]. Appl Psychophysiol Biofeedback,2007, 32(1):1-10.DOI:10. 1007/s 10484-006-902 8-0.
[21] Chalaye P, Goffaux P, Lafrenaye S, et al. Respiratory effects on experimental heat pain and cardiac activity[J]. Pain Med, 2009,10(8):1334-1340. DOI:10. 1111/j. 1526-4637. 2009. 00681. x.
[22] Pramanik T, Pudasaini B, Prajapati R. Immediate effect of a slow pace breathing exercise Bhramari pranayama on blood pressure and heart rate[J]. Nepal Med Coll J, 2010, 12(3):154-157.
[23]何亚菲,林文华.伊伐布雷定对慢性非缺血性心力衰竭患者心率变异性的影响[J].中国循环杂志,2016, 31(11):1111-1114. DOI:10.3969/j.issn.1000-3614.2016.11.016.
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