Quantitative analysis of the arterial baroreflex transient response during acute myocardial infarction toward optimized therapy

急性心肌梗死期间动脉压力反射瞬态反应的定量分析以优化治疗

基本信息

批准号：
15590786
负责人：
KAWADA Toru
金额：
$ 1.79万
依托单位：
National Cardiovascular Center Research Institute
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2004
项目状态：
已结题

项目摘要

The present study was designed to quantitatively analyze the effects of acute myocardial infarction on the cardiovascular regulation and to develop a circulatory model capable of describing hemodynamic changes during acute myocardial infarction. By using this model, hemodynamic changes during acute myocardial infarction may be described quantitatively in terms of changes in model parameters. Such a quantitative evaluation would contribute to a risk stratification of acute myocardial infarction. In addition, the prediction of the circulatory responses to drug administrations would lead to the optimized drug administrations with tide minimum total amount of drug used. In the present study, we quantified the dynamic and static characteristics of the arterial baroreflex by a transfer function analysis and an equilibrium diagram analysis, respectively. In anesthetized rabbits, activation of the vagally-mediated cardiac reflex by phenylbiguanide approximately halved the arterial baroreflex g … More ain calculated from changes in sympathetic nerve activity relative to the pressure changes. We designed an automated drug infusion system by taking into account the predicted changes in the baroreflex gain. When a classical proportional-integrative-derivative(PID) controller with fixed parameter values was used, changes in the magnitude of biological responses to a given amount of drug makes the circulatory regulation unstable. In contrast, an adaptive predictive controller with a neural network provided a stable circulatory regulation regardless of changes in the biological responses to a given amount of drug. Although the effects of acute coronary occlusion on the arterial baroreflex were examined, changes in the dynamic characteristics were not significant even when hypotension with pump failure manifested. Possible explanation for the absence of significant effects of coronary occlusion on the baroreflex gain might be an absence of vagally-mediated cardiac reflex due to vagal withdrawal under anesthetic conditions. Less

本研究旨在定量分析急性心肌梗死对心血管调节的影响，并建立能够描述急性心肌梗死期间血流动力学变化的循环模型，利用该模型可以定量描述急性心肌梗死期间的血流动力学变化。就模型参数的变化而言，这种评估将有助于对急性心肌梗死的风险进行分层，从而预测对药物给药的循环反应。在本研究中，我们分别通过传递函数分析和平衡图分析来量化麻醉兔子的动脉压力反射的动态和静态特征。苯双胍引起的迷走神经介导的心脏反射大约使动脉压力感受性反射减半，这是根据交感神经活动相对于压力变化的变化计算得出的。考虑到压力反射增益的预测变化。当使用具有固定参数值的经典比例积分微分（PID）控制器时，对给定药物量的生物反应幅度的变化会使循环调节不稳定。相比之下，无论对给定药物量的生物反应如何变化，具有神经网络的自适应预测控制器都提供了稳定的循环调节。甚至不显着当出现低血压伴泵衰竭时，冠状动脉闭塞对压力感受反射增益没有显着影响的可能解释可能是由于麻醉条件下迷走神经收缩而导致迷走神经介导的心脏反射的缺失。