Interaction of 0.1-Hz oscillations in heart rate variability and distal blood flow variability

Biophysical features of 0.1-Hz oscillations of heart rate variability (HRV) and distal blood flow (DBF) variability were compared in healthy subjects and patients after acute myocardial infarction (MI). Patients with acute MI (72 men and 53 women; 125 in total) and healthy subjects (23 men and 10 women; 33 in total) aged 30?C83 and 20?C46 years, respectively, participated in the study. The patients were involved in the study for a year after acute MI. The delay in coupling 0.1-Hz oscillations of HRV and DBF variability was estimated. In healthy subjects, the delay in the heart ?? DBF coupling proved to be less than the delay in the DBF ?? heart coupling. Acute MI results mainly in disruption of the heart ?? DBF coupling, which is partially restored by the end of the first year after acute MI, though it remains lower than in healthy subjects. The DBF ?? heart coupling is rapidly restored to the level of healthy subjects within three weeks after acute MI.     

Internal synchronization of the main 0.1-Hz rhythms in the autonomic control of the cardiovascular system

Synchronization parameters of 0.1-Hz rhythms isolated from the heart rate and the oscillations of the blood volume in microcirculatory vessels were studied in 12 healthy subjects and 32 patients with acute myocardial infarction. Recordings of the electrocardiogram and the pulsogram from the distal phalanx of the index finger, as well as mechanical recording of respiration with the body in a horizontal position, were performed. In patients with myocardial infarction, the recordings were performed during the first three to five days and the third week after the infarction. Synchronization was tested by plotting phase differences and calculating the total percentage of phase synchronization. Synchronization parameters of 0.1-Hz rhythms were high in healthy subjects. In patients with acute myocardial infarction, synchronization of 0.1-Hz rhythms was considerably poorer. The data obtained suggest that the studied 0.1-Hz rhythms are two independent oscillatory processes that are synchronized in healthy subjects. However, this interaction may be disturbed in cardiovascular pathologies, e.g., myocardial infarction.     

Involvement of the sympatho-vagal balance in the formation of respiration-dependent oscillations in the human cardiovascular system

The effect of deep breathing controlled in both rate and amplitude on the heart rate variability (HRV) and respiration-dependent blood flow oscillations was studied in the forearm and finger-pad skin of healthy 18- to 25-year-old volunteers. In order to reveal the effects of the divisions of the autonomic nervous system on the amplitudes of respiratory sinus arrhythmia (RSA) and skin blood flow oscillations, we studied the indices of the cardiovascular system in two groups of subjects with respectively lower and higher values of the sympatho-vagal balance. This index was calculated as a ratio of low frequency and high frequency HRV spectral power (LF/HF) under the conditions of spontaneous breathing. It was found that, in subjects with a predominant parasympathetic tone, the amplitudes of RSA and the rate of blood flow in the finger-pad skin were higher compared to subjects with a predominant sympathetic tone during respiration with the frequency lower than 4 cycle/min. In the forearm skin, where sympathetic innervation is weaker compared to the finger-pad skin, there were no significant differences in respiration-dependent oscillations of the rate of blood flow in two groups of subjects.     

Investigation of biophysical features of interaction between 0.1 Hz oscillations in heart rate variability and distal blood flow variability

We studied biophysical features of interaction between 0.1 Hz oscillations in heart rate variability (HRV) and distal blood flow (DBF) variability in healthy subjects and patients after acute myocardial infarction (MI). 125 patients after acute MI (72 male and 53 female) aged between 30 and 83 years and 33 healthy subjects (23 male and 10 female) aged between 20 and 46 years were included in the study. The duration of prospective study of MI patients was one year. We estimated the delay in coupling between 0.1 Hz oscillations in H RV and DBF variability. It is found out that in healthy subjects the delay in coupling from heart rate to DBF is less than delay in coupling from DBF to heart rate. Acute MI results mainly in disruption of coupling from heart rate to DBF. This coupling is partially restored in one year after acute MI, but the delay in coupling remains significantly smaller than in healthy subjects. The features of coupling from DBF to heart rate are restored in MI patients within three weeks after infarction. After this period the delay in this coupling in MI patients is approximately the same as it is in healthy subjects.     

Phase and frequency locking of 0.1-Hz oscillations in heart rate and baroreflex control of blood pressure by breathing of linearly varying frequency as determined in healthy subjects

Functional interaction was studied between the subsystems that ensure autonomic control of the heart rate (HR) and blood pressure (BP) and give rise to 0.1-Hz oscillations in R-R intervals (RRI) and photoplethysmogram (PPG). Twenty-five recordings were obtained from 18- to 32-year-old healthy persons (six women and nineteen men). The RRI and PPG were recorded simultaneously while the respiration rate of a subject in the sitting position increased linearly from 0.05 Hz to 0.25 Hz within 25 min. Phase and frequency locking of 0.1-Hz oscillations by breathing proved to be possible in both RRI and PPG. The intervals of phase and frequency locking of oscillations by respiration differed in duration and relative position. These distinctions suggest that the mechanisms of autonomic 0.1-Hz control of HR and BP are functionally independent.     

Adaptive wavelet analysis of oscillations in the human peripheral blood flow

The main principles are outlined for spectral timing analysis of the peripheral blood flow oscillations obtained by laser Doppler flowmetry. The oscillations can be studied in a wide frequency range both in stationary and nonstationary conditions during functional tests. The potential of the method has been demonstrated in experiments with the reaction of the microvascular bed to transcutaneous iontophoretic introduction of acetylcholine chloride. The major advantage of the method over conventional wavelet analysis is a significant increase in the “effective” length of the signal analyzed, which allows correct analysis of low-frequency components in much shorter LDF recordings than those commonly used.     

Baroreflex modulation of ultradian oscillations of blood pressure and heart rate in unanesthetized dogs

Telemetered, free-running dogs were studied to determine the role of cardiovascular control systems in modulation of ultradian oscillations of arterial pressure (MAP) and heart rate (HR). Data, aquired (2 Hz) by a stable telemetry system, was stored on a digital computer and analyzed for its harmonic content by a Fast Fourier Transform (FFT) algorithm. Both AP and HR consistently demonstrated rhythms having a period of from 0.6 to 1.0 h. Modulation of these rhythms by arterial pressure control systems was assessed in dogs studied before and carotid sinus baroreceptor denervation, before and after denervation of the aortic arch baroreceptors and before and after a combination of both these procedures. The data indicate the power spectral density (PSD) of MAP, but not HR, is increased (p less than 0.05) after denervation of the carotid sinuses alone, while the primary frequency of the oscillations was unchanged. On the other hand, denervation of the aortic arch baroreceptors alone was without effect on either the frequency or PSD of these oscillations. A combination of both carotid sinus and aortic arch denervation resulted in an increased (p less than 0.05) PSD of MAP oscillations but not in their frequency. These data indicate that the carotid sinuses modulate rhythmic behavior of MAP by buffering the magnitude, but not frequency, of the oscillations. Moreover, since oscillations were present in dogs after denervation of both the carotid sinus and aortic arch baroreceptors, these ultradian oscillations are not a result of a non-linear negative feedback mechanisms arising from these pressure sensitive regions.     

Involvement of sympathetic nerve activity in skin blood flow oscillations in humans

We have used the wavelet transform to evaluate the time-frequency content of laser-Doppler flowmetry (LDF) signals measured simultaneously on the surfaces of free microvascular flaps deprived of sympathetic nerve activity (SNA), and on adjacent intact skin, in humans. It was thereby possible to determine the frequency interval within which SNA manifests itself in peripheral blood flow oscillations. The frequency interval from 0.0095 to 2 Hz was examined and was divided into five subintervals: I, approximately 0.01 Hz; II, approximately 0.04 Hz; III, approximately 0.1 Hz; IV, approximately 0.3 Hz; and V, approximately 1 Hz. The average value of the LDF signal in the time domain as well as the mean amplitude and total power in the interval from 0.0095 to 2 Hz and amplitude and power within each of the five subintervals were significantly lower for signals measured on the free flap (P < 0.002). The normalized spectral amplitude and power in the free flap were significantly lower in only two intervals: I, from 0.0095 to 0.021 Hz; and II, from 0.021 to 0.052 Hz (P < 0.05); thus indicating that SNA is manifested in at least one of these frequency intervals. Because interval I has recently been shown to be the result of vascular endothelial activity, we conclude that we have identified SNA as influencing blood flow oscillations in normal tissues with repetition times of 20-50 s or frequencies of 0.02-0.05 Hz.     

Cardiac and respiratory oscillations of the blood flow in microvessels of the human skin

Laser Doppler flowmetry with wavelet analysis, spectrophotometry, computer-aided capillaroscopy, and thermometry were used to study cardiac and respiratory oscillations of the blood flow in the skin microvessels of 30 subjects. The amplitudes of the cardiac and respiratory rhythms (A_c and A_r, respectively) were found to be determined predominantly by the distribution of perfusion and pressure in larger vessels (arterioles and venules). The cardiorespiratory coupling is a regulatory factor in the microcirculatory system; at rest, the value of A_c/A_r reflects the capillary arteriovenous ratio. In the structure of the microcirculation index (MI) and A_c, the velocity-to-volume ratio depends on the perfusion of the corresponding skin region: at rest, the volume-related component is expressed only in the skin with arteriolovenular anastomoses, whereas, in the skin without these anastomoses, MI and A_c are predominantly correlated with the dynamic velocity-related component. A_c is inversely dependent on both stationary and oscillatory components of the microvascular tone. The nature of the respiratory wave depends not only on the respiratory modulation of the venous outflow, but also on the perfusion pressure in the microvessels and venular hematocrit. The correlation of A_r with the total blood flow in the skin microvessels and the individual contributions of velocity-and volume-related components to A_r were significant only in situations where the blood flow was above a certain threshold, below which the respiratory waves can penetrate into the microvessels but their correlation with the total perfusion is nonsignificant.     

Morphologic mechanisms of blood flow regulation in the hemomicrocirculatory system of the human heart during ontogenesis

Hearts of 220 human corpses, who had not any cardiovascular system disease during their life, have been distributed into age groups, beginning from fetuses up to old age. By means of injection, silver nitrate impregnation and scanning electron microscopy methods, applied to corrosive preparations, morphological mechanisms of the blood stream regulation in the hemomicrocirculatory bed of the human heart have been revealed in ontogenesis. The first group of the regulation mechanisms includes proper mechanisms inherent in the links of the microbed: spatial orientation of microvessels, precapillary sphincters, anastomoses between these vessels, sequence in arrangement of the endothelial cell nuclei, length, diameter and number of links in the microcirculatory bed. The second group embraces those mechanisms, that depend on structure of the myocardial wall, influencing the microcirculatory bed.     

Role of eicosanoids in the cardiovascular system

Cardiovascular eicosanoids are of significance in relation to regulation of hemostasis and flow under healthy and pathological conditions. In healthy subjects, TxA2 and PGI2 participate in the maintenance of vascular integrity in relation to vascular injury. In this respect, vascular eicosanoids can be regarded as constituents of a balancing system which favours platelet deaggregation in intact vessels but platelet aggregation in a injured vessel. Degenerative arterial disease, like e.g. atherosclerosis, disturbs the balance and favours platelet activation and adhesion to vascular surfaces. This may promote the development of platelets thrombi in the absence of vascular injury and lead to thrombosis.     

Role of the renin-angiotensin system in regulation and autoregulation of renal blood flow

The role for ANG II in renal blood flow (RBF) autoregulation is unsettled. The present study was designed to test the effect of clamping plasma ANG II concentrations ([ANG II]) by simultaneous infusion of the angiotensin-converting enzyme inhibitor captopril and ANG II on RBF autoregulation in halothane-anesthetized Sprague-Dawley rats. Autoregulation was defined as the RBF response to acute changes in renal perfusion pressure (RPP). Regulation was defined as changes in RBF during long-lasting changes in RPP. The results showed that a prolonged reduction of RPP reset the lower limit of autoregulation from 85 +/- 1 to 73 +/- 2 mmHg (P < 0.05) and regulated RBF to a lower level. Reduction of RPP to just above the lower limit of autoregulation (88 mmHg) induced regulation of RBF to a lower level within 10 min. Clamping [ANG II] per se reset the lower limit of autoregulation to 62 +/- 5 mmHg. In this case, reduction in RPP to 50 mmHg did not induce a downregulation of RBF. We conclude that ANG II plays an important role in the resetting of the autoregulation limits. The ability to regulate RBF to a new level as a response to changes in RPP also depends on changes in [ANG II].     

Resonance oscillations in the human arterial system]

The paper summarizes the results of the experiments aimed at obtaining sphygmograms of peripheral and carotid arteries with due regard to the values of longitudinal dimensions of body and extremities in healthy subjects. Mathematical equations expressing the fact that dicrotic waves recorded on sphygmograms are the reflections of blood eigentones coinciding with resonance oscillations have been derived. It is proved that at least two partial vibration systems oscillating with different own frequencies are present in human arteries. Conditions under which the resonance of constituent frequencies of pulsatile pressure waves and output waves in arteries occurs have been determined. From this point of view a new explanation for the well-known phenomenon of the pulsatile wave amplitude increase from the heart towards peripheric regions is proposed.     

环鸟苷酸依赖的蛋白激酶对心血管功能的调节作用

环鸟苷酸(cGMP)依赖的蛋白激酶(PKG)是一氧化氮-cGMP的主要细胞内受体,在哺乳动物细胞中分为PKG-I和PKG-II两型。在PKG介导的血管平滑肌舒张作用中,其主要通过活化细胞膜上的钙活化的钾通道(BK通道),磷酸化肌质网上的受磷蛋白(phospholamban,PLB)和三磷酸肌醇受体相关的PKG-I底物(IP3receptor-associated PKG-I substrate,IRAG),降低细胞内Ca2 浓度。PKG还可通过活化肌球蛋白轻链磷酸酶及抑制Rho激酶降低肌球蛋白对Ca2 敏感性。PKG调节血管平滑肌细胞的基因表达和表型调变,调节细胞增生。PKG活化以后还具有抑制血小板聚集,抑制心肌细胞肥大等功能。最近的研究证明,PKG的表达水平和活性改变与动脉粥样硬化和再狭窄、高血压、糖尿病心血管病变以及硝酸盐耐受等的发病机制有密切关系。     

中枢血管紧张素对心血管活动调节作用

血管紧张素(Ang)广泛存在于中枢神经系统和外周组织中,对心血管活动和交感神经活动起重要调节作用。本文介绍了孤束核(NTS)、延髓头端腹侧区(RVLM)、延髓尾端腹侧区(CVLM)和室旁核(PVN)内Ang对心血管活动的影响,Ang对动脉压力感受性反射(ABR)和心交感传入反射(CSAR)的调节作用,肾素-血管紧张素系统的基因敲除研究,以及Ang与高血压和慢性心力衰竭的关系。     

Multivariate and multidimensional analysis of cardiovascular oscillations in patients with heart failure.

Within 5 years of first diagnosis, nearly 60% of patients with heart failure (HF) suffer from cardiac death. Early diagnosis of HF and reliable risk prediction are still required. Therefore, the objective of this study was to develop a parameter set for enhanced risk stratification in HF patients. In 43 patients suffering from HF (NYHA class > or =II, ejection fraction <45%) and 10 healthy subjects (REF), heart rate and blood pressure variability (HRV and BPV), interactions between heart rate and blood pressure (joint symbolic dynamics, JSD) and blood pressure morphology (BPM) were analysed. BPV, BPM and JSD measures revealed high significance (p<0.0001) in discriminating REF and HF. A set of three parameters from BPV, JSD and BPM was developed for risk stratification (sensitivity 76.5%, specificity 84.2%, area under the receiver operating characteristic curve 81.4%) in patients with HF.