Effects of nicardipine and diltiazem on fractal features of short-term heart rate variability - Application of coarse graining spectral analysis

被引：8

作者：

Koh J. ^{[1
]}

Hidaka I. ^{[2
]}

Miyata M. ^{[3
]}

机构：

[1] Department of Anesthesia, National Hospital, Kure Medical Center, Kure

[2] Laboratory for Exercise Physiology and Biomechanics, Faculty of Education, University of Tokyo, Tokyo

[3] Institute for Clinical Research, National Hospital, Kure Medical Center, Kure

来源：

Journal of Anesthesia | 2002年 / 16卷 / 2期

关键词：

1/f[!sup]β[!/sup] fluctuation; Diltiazem; Heart rate variability; Nicardipine;

D O I：

10.1007/s005400200003

中图分类号：

学科分类号：

摘要：

Purpose. This study was designed to investigate the effects of nicardipine and diltiazem on the fractal features of short-term heart rate variability (HRV), using coarse graining spectral analysis (CGSA). Methods. Eighteen healthy volunteers participated in this study; they were divided into two groups according to the drug administered. Five-minute electrocardiogram and arterial pressure recordings were made during stepwise infusions of either nicardipine (0.4, 0.8, 1.6, and 3.2 μg·kg-1·min-1) or diltiazem (2, 4, 8, and 16 μg·kg-1·min-1) under rate-controlled breathing at 0.25 Hz. CGSA broke down the total power of the time series into harmonic (low frequency [0.0-0.15 Hz; LF] and high frequency [0.15-0.5 Hz; HF]) and nonharmonic (fractal) components. Cardiac sympathetic nervous system (SNS) and parasympathetic nervous system (PNS) activity indicators were evaluated as the ratios LF/HF and HF/TP (total spectral power), respectively. Fractal components were evaluated as %fractal and the spectral exponent β of 1/fβ. Results. Compared with control measurements, the maximum dose of nicardipine infusion caused a significant decrease in systolic arterial pressure, a significant increase in the mean heart rate, and a significant increase in plasma norepinephrine level, findings that were associated with significant increases in %fractal and β values (54.2 ± 13.3 vs 75.6 ± 9.8, and 0.86 ± 0.22 vs 1.32 ± 0.46, respectively; P < 0.05). PNS and SNS indicators showed decreased and increased values, respectively. Diltiazem caused a reduction in arterial pressure; however, no other parameters, including the nonharmonic components of HRV, were affected by this drug. Conclusions. These findings strongly suggest that nicardipine suppresses vagal cardiac neural outflow and activate the SNS, an action which, subsequently, causes changes in the fractal features of HRV. Although diltiazem reduces arterial pressure, it preserves the basic neural balance of the autonomic nervous system in regard to heart rate control.

引用

页码：108 / 113

页数：5

共 32 条

[1]

Mikawa K., Nishina K., Maekawa N., Obara H., Comparison of nicardipine, diltiazem and verapamil for controlling the cardiovascular responses to tracheal intubation, Br. J. Anaesth, 76, pp. 221-226, (1996)

[2]

Grossman E., Messerli F.H., Effect of calcium antagonists on plasma norepinephrine levels, heart rate, and blood pressure, Am. J. Cardiol, 80, pp. 1453-1458, (1997)

[3]

Conrad K.A., Fagan T.C., Mayshar P., Davis T.P., Johnson D.G., Antihypertensive effects of parenteral nicardipine alone and in combination with captopril, Clin. Pharmacol. Ther, 42, pp. 113-118, (1987)

[4]

Ryman K.S., Kubo S.H., Shaknovich A., Cody R.J., Influence of baseline hemodynamic status and sympathetic activity on the response to nicardipine, a new dihydropyridine, in patients with hypertension or chronic congestive heart failure, Clin. Pharmacol. Ther, 41, pp. 483-489, (1987)

[5]

Amodeo C., Kobrin I., Ventura H.O., Messerli F.H., Frohlich E.D., Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension, Circulation, 73, pp. 108-113, (1986)

[6]

Yeung P.K., Hung O.R., Pollak P.T., Klassen G.A., Pharmacokinetics and hemodynamic effects of diltiazem in healthy volunteers: Comparing resting with the effects of exercise, Int. J. Clin. Pharmacol. Ther, 37, pp. 413-416, (1999)

[7]

Heart rate variability: Standards of measurements, physiological interpretation, and clinical use, Circulation, 93, pp. 1043-1065, (1996)

[8]

Bekheit S., Tangella M., el-Sakr A., Rasheed Q., Craelius W., el-Sherif N., Use of heart rate spectral analysis to study the effects of calcium channel blockers on sympathetic activity after myocardial infarction, Am. Heart J, 119, pp. 79-85, (1990)

[9]

Yamasaki F., Sato T., Sugimoto K., Takata J., Chikamori T., Sasaki M., Doi Y., Effect of diltiazem on sympathetic hyperactivity in patients with vasospastic angina as assessed by spectral analysis of arterial pressure and heart rate variability, Am. J. Cardiol, 81, pp. 137-140, (1998)

[10]

Frey A.W., Muller C., Dambacher M., Theisen K., Increased vagal activity after administration of the calcium antagonist diltiazem in patients with coronary heart disease, Z. Kardiol, 84, pp. 105-111, (1995)

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