This action might not be possible to undo. Are you sure you want to continue?
Reactions of the heart rate and carotid artery pulse wave components to the nitroglycerin uptake. Kaunas Univerity of Medicine, Annual Report”99, 2000, P –163-164.
INSTITUTE OF PSYCHOPHYSIOLOGY AND RAEBILITATION NEUROPSYCHOLOGY LABORATORY REACTIONS OF THE HEART RATE AND CAROTID ARTERY PULSE WAVE COMPONENTS TO THE NITROGLYCERINE UPTAKE A. Stankus, A. Alonderis, J. Varoneckiene Nitroglycerine (NTG) is a potent and reliable agent for decreasing the left and right ventricular filling pressure in the normal heart, as well as in a subject with congestive heart failure and high pulmonary capillary pressure. We made a premise that systemic changes of the blood vessel wall and heart contraction may affect carotid artery pulse wave phase characteristics: carotid artery dilates more or less, decreases or increases the impulsation from baroreceptors. Aim of the study is to assess reaction of the heart rate, its variability and blood circulation changes during the nitroglycerine test. Methods: In this experiment, we used the methods of the polygraphy. We are recording changes in pulsation of the carotid artery by the local electroimpedance registration method and heart rate. The pulse wave amplitude is measured by means of volume units (ml/l). Recorded in the carotid artery projection, pulse wave was entered through an analogue-to-digital converter into personal computer IBM-486 by using prepared algorithms, and in each pulse wave amplitudes of early systolic peak (ESP) and late systolic peak (LSP) were separated. The subject during the investigation time is in sitting position, relaxed. In the first stage (5 min.) of our investigation registration of the electrocardiogram, rhytmogram and relative changes of the carotid artery pulse wave amplitude was performed. In the second stage to the investigated person is given 2.5 mg nitroglycerine sublingually, and registration of the previous parameters with the changes that occurred after nitroglycerine uptake during 12 minutes continues. All the registered time series were cleaned from artefacts and stored as files. This way we got 3 time series. A multivariate spectral analysis of the analysed parameters was performed. Mean values and variabilities were calculated from time series each minute of the NTG test. Results:The contingent was a group (n= 204 subjects, male-143, female-61). The vasomotor tone index (ratio LSP/ESP) was 28.3± 13.97 and changed from 0 to 68 %. This result may be from inadequate NTG dose or nitrate tolerance occurrence. ESP reaction during NTG test was significant. Changes of the LSP during the test were minimal. During 12 minutes after nitroglycerine uptake, carotid artery vasomotor tone index not returned to the initial level. With decrease of the vasomotor tone, at the same time heart rate increased (11.3± 6.14 %). Dependence of the vasomotor tone and heart rate reaction may be expressed by regression ratio %RR= 3.718± 1.7*(LSP/ESP). Maximal heart rate increase was 30 %. Also it was found, that heart rate reaction to the nitroglycerine is not always adequate to the vasomotor tone reaction. Investigated subjects were divided into 3 groups according to initial heart rate increase, compared to initial heart rate level. In the I group are patients with difference of the relative heart rate and vasomotor tone reaction less, than 11% (n= 66), in the II group this difference was 11-25% (n= 88) and in III group >25% (n= 55). In the I and II groups reaction to the nitroglycerine uptake was adequate to the changes of the vasomotor tone. In the II group heart rate reaction was significantly decreased. Magnitude of this reaction not depended on the initial heart rate level. In the I group ESP was highest (1.20-0.4 ml/l) and in the III group it was lowest (0.92-0.28 ml/l, p<0.01). The same regularity observed also with the LSP (p>0.001). These results confirm, that changes in the arterial wall are closely related with the changes of the homodynamic and heart rate. Conclusion: Heart rate and vasomotor tone index are related parameters, and they are partially reflecting status of the systemic homodynamic. Decreased heart rate reaction to the nitroglycerine uptake shows inadequate response of the systemic homodynamic to the vascular wall changes.