AUTONOMIC NERVOUS FUNCTION OF VERTIGINOUS PATIENTS:ASSESSMENT BY SPECTRAL ANALYSIS OF HEART RATE VARIABILITY
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Autonomic nervous function in 68 vertiginous patients and 33 controls was studied using power spectral analysis of heart rate variability.<BR>First, a system was developed which computes the power spectral density (PSD) of beat-tobeat heart intervals using a continuous non-invasive finger blood pressure recording obtained with the FINAPRESS device. A fast-Fourier transform algorithm was used to compute the PSD. In frequencies up to 0.5Hz, the PSD of heart rate variability contains three major components: a low frequency (P<SUB>1</SUB>), a middle frequency (P<SUB>2</SUB>) and a high frequency (P<SUB>3</SUB>). Each component was normalized by dividing the absolute values by total power (T), and then used as an index of each component.<BR>Second, the effects of passive tilt, respiratory frequency and specific pharmacological sympathetic or parasympathetic blockade on the indices of these components were evaluated in the control group.<BR>The following results were obtained.<BR>1. During passive tilt, the normalized power of P<SUB>2</SUB> was increased, whereas that of P<SUB>3</SUB> was decreased.<BR>2. The peak frequency of P<SUB>3</SUB> was consistent with the frequency of respiration.<BR>3. Sympathetic blockade decreased the normalized power of P<SUB>2</SUB>, whereas parasympathetic blockade decreased the normalized power of P<SUB>3</SUB>.<BR>From these results, I concluded that the normalized power of P<SUB>2</SUB> and P<SUB>3</SUB> are quantitative markers of sympathetic and vagal nervous activities, respectively.<BR>Third, the results of spectral analysis in patients were compared with those in controls.<BR>The following characteristics of autonomis nervous function in vertiginous patients were noted.<BR>1. The normalized power of P<SUB>3</SUB> in patients was lower than that in controls, suggesting that parasympathetic nervous activity at rest was suppressed in patients.<BR>2. The increase of normalized power of P<SUB>2</SUB>with passive tilt was suppressed in patients, suggesting suppression of sympathetic response to passive tilt.<BR>3. In patients with Meniere's disease, during the active period of vertigo attacks, the normalized power of P<SUB>2</SUB>, which is an index of sympathetic activity, was higher than that in the intervals between vertigo attacks.<BR>Fourth, with caloric stimulation in the control group, an increase of the normalized power of P<SUB>2</SUB>was observed during or after the stimulation, which suggests that vestibular stimulation increases sympathetic activity.<BR>I therefore suggest the following:<BR>1. Decreased parasympathetic activity and suppression of sympathetic response were present in the vertiginous patients.<BR>2. Sympathetic activity was increased by vertigo attacks in the patients with Meniere's disease.
- 一般社団法人 日本耳鼻咽喉科学会の論文
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- AUTONOMIC NERVOUS FUNCTION OF VERTIGINOUS PATIENTS:ASSESSMENT BY SPECTRAL ANALYSIS OF HEART RATE VARIABILITY
- ラマトロバンの鼻アレルギー臨床第皿相試験-テルフェナジンとの比較-