单侧和双侧肢体浸泡对冷加压试验的全身和大脑血流动力学反应的影响。

IF 3.3 3区 医学 Q1 PHYSIOLOGY
Journal of applied physiology Pub Date : 2024-10-01 Epub Date: 2024-08-01 DOI:10.1152/japplphysiol.00328.2024
Elric Y Allison, Yixue Mei, Geoff B Coombs, Vanessa Mizzi, Huseyn Ismayilov, Baraa K Al-Khazraji
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引用次数: 0

摘要

冷压试验(CPT)是指在冷水中浸泡上肢或下肢,通过刺激痛觉和皮肤热敏感受器引起自律神经和血流动力学的增强。目前还不清楚 CPT 研究中肢体的选择是否会对全身和大脑血流动力学反应产生不同影响。在此,我们评估了手部(CPTH)、足部(CPTF)或双足(CPTBF)对不同 CPT 方案的全身和大脑血流动力学及通气反应。我们假设 CPTBF 会因暴露于冷刺激的面积增加而引起最大的生理反应。方法。28 名(14 男;14 女)健康的年轻人[23.4(标准差:2.4)岁]在一次就诊中参加了三个 3 分钟的 CPT 方案。在整个 CPT 方案中记录了平均动脉压 (MAP)、心率 (HR)、大脑中动脉血流速度 (MCAv) 和脑血管传导指数、潮气末二氧化碳 (PETCO2) 以及痛觉。结果显示与 CPTH(Δ4.85(12.6)BPM;p=0.01)和 CPTF(Δ4.04(13.3)BPM;p=0.02)相比,ppBF(Δ13.6(15.5)BPM)和 CPTF(Δ4.04(13.3)BPM;p=0.02)的收缩压和舒张压存在时间与 CPT 方案的交互作用。与 CPTF(Δ8.42(7.12)mmHg;P0.01)相比,CPTH(Δ12.3(7.95)mmHg)和 CPTBF(Δ12.9(9.24)mmHg)的 Delta MAP 更大。与单肢方案相比,CPTBF 的疼痛感更高(p≤0.01)。结论。我们的研究结果表明,在 CPT 方案中选择肢体会影响全身血流动力学反应,在设计 CPT 研究时应加以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of single- and bilateral limb immersion on systemic and cerebral hemodynamic responses to the cold pressor test.

The cold pressor test (CPT) involves cold water immersion of either the upper or lower limb(s) and elicits increases in sympathetic nervous activity (SNA), heart rate (HR), and mean arterial pressure (MAP) via stimulation of pain and cutaneous thermoreceptors. Greater pain perception during the CPT is associated with greater increases in SNA and more robust physiological responses. Due to potential differential sensitivity to both painful and thermal stimuli between upper and lower limbs, as well as potential effects of total exposure area, it is unclear whether the choice of limb(s) in CPT protocol design differentially affects systemic and cerebral hemodynamic responses. Our objective was to assess systemic and cerebral hemodynamic and ventilatory responses to different CPT protocols of the hand (CPTH), foot (CPTF), or bilateral feet (CPTBF). We hypothesized CPTBF would elicit greatest physiological responses due to increased exposure area to the cold stimulus. Twenty-eight (14 M, 14 F) healthy young adults [23.4 (SD: 2.4) yr] participated in three 3-min CPT protocols during a single visit. Blood pressure, HR, middle cerebral artery blood velocity (MCAv) and cerebrovascular conductance index, and end-tidal carbon dioxide ([Formula: see text]) were averaged over the final 30 s of each minute of the CPT for each protocol, and perceived pain was recorded at the end of each minute of the CPT. We found significant effects of the time-CPT protocol interaction on systolic blood pressure (P = 0.02), diastolic blood pressure (P < 0.01), MAP (P < 0.01), and HR (P < 0.001). There were no differences between CPT protocols on either MCAv (P = 0.4) or cerebrovascular conductance index (P = 0.1). HR responses peaked in the first minute of the CPT, and changes from baseline were greater in CPTBF [Δ14(16) beats/min] compared with CPTH [Δ5(13) beats/min; P = 0.01] and CPTF [Δ4.04(13.3) beats/min; P = 0.02]. MAP responses peaked in minute 2 of the CPT, and changes from baseline were greater in CPTH [Δ12(8) mmHg) and CPTBF (Δ13(9) mmHg] compared with CPTF [Δ8(7) mmHg; P < 0.01]. Perceived pain was significantly greater in the CPTBF [CPT1 7(2.3), CPT2 6.5(2.3), CPT3 6(3)] condition compared with CPTH [CPT1 6(1.3), CPT2 6(2.3), CPT3 6(2.3)] and CPTF [CPT1 6(3.0), CPT2 6(2.0), CPT3 5.5(3.0)] protocols at all three stages of the CPT (P ≤ 0.01). Our findings suggest choice of limb(s) in CPT protocols may lead to differences in systemic hemodynamic responses, with pain perception potentially influencing these responses. Based on our results, we suggest that choice of limb should be considered in future design of CPT studies, with hand CPT providing the best balance between participant tolerability and robust physiological responses.NEW & NOTEWORTHY Choice of limb(s) in cold pressor test (CPT) studies appears to influence systemic hemodynamics. Hand and bilateral feet induce more robust responses than single-foot CPT, potentially due to increased exposure area and pain perception. Despite no significant cerebrovascular effects, a sustained hyperventilatory response was noted in bilateral feet CPT. Hand CPTs may provide a balance between robust physiological responses and tolerability. These findings underscore the need for careful limb selection in future CPT studies.

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来源期刊
CiteScore
6.00
自引率
9.10%
发文量
296
审稿时长
2-4 weeks
期刊介绍: The Journal of Applied Physiology publishes the highest quality original research and reviews that examine novel adaptive and integrative physiological mechanisms in humans and animals that advance the field. The journal encourages the submission of manuscripts that examine the acute and adaptive responses of various organs, tissues, cells and/or molecular pathways to environmental, physiological and/or pathophysiological stressors. As an applied physiology journal, topics of interest are not limited to a particular organ system. The journal, therefore, considers a wide array of integrative and translational research topics examining the mechanisms involved in disease processes and mitigation strategies, as well as the promotion of health and well-being throughout the lifespan. Priority is given to manuscripts that provide mechanistic insight deemed to exert an impact on the field.
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