Circulation, Vol 81, 537-547, Copyright © 1990 by American Heart Association
R Furlan, S Guzzetti, W Crivellaro, S Dassi, M Tinelli, G Baselli, S Cerutti, F Lombardi, M Pagani and A Malliani
In this study, we tested the hypothesis that the neural control of
circulation in humans undergoes continuous but in part predictable changes
throughout the day and night. Dynamic 24-hour recordings were obtained in
two groups of ambulant subjects. In 18 hospitalized patients free to move,
direct high-fidelity arterial pressures and electrocardiograms were
recorded, and in an additional 28 nonhospitalized subjects, only
electrocardiograms were obtained. Spectral analysis of systolic arterial
pressure and of RR interval variabilities provided quantitative markers of
sympathetic and vagal control of the sinus node and of sympathetic
modulation of vasomotor tone. With this approach, the low-frequency
(approximately 0.1 Hz) component of RR interval and systolic arterial
pressure variabilities is considered a marker primarily of sympathetic
activity, whereas the high-frequency (approximately 0.25 Hz) component of
RR interval variability, related to respiration, seems to be a marker
primarily of vagal activity. We observed a pronounced and consistent
reduction in the markers of sympathetic activity and an increase in those
of vagal activity during the night. In the invasive studies, while the
subjects were still lying in bed after waking up, the markers of
sympathetic activity rose rapidly and concomitantly with a simultaneous
vagal withdrawal. Noninvasive studies confirmed the early morning rise of
the markers of sympathetic activity and the circadian pattern of
sympathovagal balance. These data indicate that the ominously increased
rate of cardiovascular events in the morning hours may reflect the sudden
rise of sympathetic activity and the reduction of vagal tone.
ARTICLES
Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects
Istituto Ricerche Cardiovascolari, Centro Ricerche Cardiovascolari CNR, Milano, Italy.
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