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The cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia: Associations with pain, affective impairments, sleep problems, and fatigue
Psychophysiology ( IF 3.7 ) Pub Date : 2021-03-01 , DOI: 10.1111/psyp.13800 Gustavo A Reyes Del Paso 1 , Ana M Contreras-Merino 1 , Pablo de la Coba 1 , Stefan Duschek 2
Psychophysiology ( IF 3.7 ) Pub Date : 2021-03-01 , DOI: 10.1111/psyp.13800 Gustavo A Reyes Del Paso 1 , Ana M Contreras-Merino 1 , Pablo de la Coba 1 , Stefan Duschek 2
Affiliation
This study investigated the cardiac, vasomotor, and myocardial branches of the baroreflex in fibromyalgia using the spontaneous sequence method. Systolic blood pressure (SBP), interbeat interval (IBI), stroke volume (SV), pre‐ejection period (PEP), and total peripheral resistance (TPR) were continuously recorded in 40 fibromyalgia patients and 30 healthy individuals during a cold pressor test and a mental arithmetic task. Sequences of covariation between SBP and IBI (cardiac branch), SV and PEP (myocardial branch), and TPR (vasomotor branch) were identified. Baroreflex sensitivity (BRS) was represented by the slope of the regression line between values in the sequences; baroreflex effectiveness (BEI) was indexed by the proportion of progressive SBP changes that elicited reflex responses. Patients exhibited lower BRS in the three branches, lower BEI in the cardiac and vasomotor branches, and reduced reactivity in cardiac BRS and BEI, SBP, IBI, SV, and PEP. Moreover, BRS and BEI were inversely related to clinical pain, cold pressor pain, depression, trait anxiety, sleep problems, and fatigue. Reduced function of the three baroreflex branches implies diminished resources for autonomic inotropic, chronotropic, and vascular regulation in fibromyalgia. Blunted stress reactivity indicates a limited capacity for autonomic cardiovascular adjustment to situational requirements. The associations of BRS and BEI with pain perception may reflect the antinociceptive effects arising from baroreceptor afferents, where reduced baroreflex function may contribute to the hyperalgesia characterizing fibromyalgia. The associations with affective impairments, sleep problems, and fatigue suggest that baroreflex dysfunctions are also involved in the secondary symptoms of the disorder.
中文翻译:
纤维肌痛中压力反射的心脏、血管舒缩和心肌分支:与疼痛、情感障碍、睡眠问题和疲劳的关联
本研究使用自发序列方法调查了纤维肌痛中压力反射的心脏、血管舒缩和心肌分支。在冷加压试验期间,连续记录 40 名纤维肌痛患者和 30 名健康个体的收缩压 (SBP)、搏动间期 (IBI)、每搏输出量 (SV)、射血前期 (PEP) 和总外周阻力 (TPR)和心算任务。确定了 SBP 和 IBI(心脏分支)、SV 和 PEP(心肌分支)以及 TPR(血管舒缩分支)之间的协变序列。压力反射敏感性(BRS)由序列中值之间的回归线的斜率表示;压力反射有效性 (BEI) 由引起反射反应的进行性 SBP 变化的比例来衡量。患者在三个分支中表现出较低的 BRS,降低心脏和血管舒缩分支的 BEI,降低心脏 BRS 和 BEI、SBP、IBI、SV 和 PEP 的反应性。此外,BRS 和 BEI 与临床疼痛、冷压疼痛、抑郁、特质焦虑、睡眠问题和疲劳呈负相关。三个压力反射分支的功能降低意味着纤维肌痛中自主肌力、变时性和血管调节的资源减少。钝化的应激反应表明自主心血管适应情境要求的能力有限。BRS 和 BEI 与疼痛感知的关联可能反映了压力感受器传入的镇痛作用,其中压力反射功能降低可能导致以纤维肌痛为特征的痛觉过敏。与情感障碍、睡眠问题、
更新日期:2021-04-15
中文翻译:
纤维肌痛中压力反射的心脏、血管舒缩和心肌分支:与疼痛、情感障碍、睡眠问题和疲劳的关联
本研究使用自发序列方法调查了纤维肌痛中压力反射的心脏、血管舒缩和心肌分支。在冷加压试验期间,连续记录 40 名纤维肌痛患者和 30 名健康个体的收缩压 (SBP)、搏动间期 (IBI)、每搏输出量 (SV)、射血前期 (PEP) 和总外周阻力 (TPR)和心算任务。确定了 SBP 和 IBI(心脏分支)、SV 和 PEP(心肌分支)以及 TPR(血管舒缩分支)之间的协变序列。压力反射敏感性(BRS)由序列中值之间的回归线的斜率表示;压力反射有效性 (BEI) 由引起反射反应的进行性 SBP 变化的比例来衡量。患者在三个分支中表现出较低的 BRS,降低心脏和血管舒缩分支的 BEI,降低心脏 BRS 和 BEI、SBP、IBI、SV 和 PEP 的反应性。此外,BRS 和 BEI 与临床疼痛、冷压疼痛、抑郁、特质焦虑、睡眠问题和疲劳呈负相关。三个压力反射分支的功能降低意味着纤维肌痛中自主肌力、变时性和血管调节的资源减少。钝化的应激反应表明自主心血管适应情境要求的能力有限。BRS 和 BEI 与疼痛感知的关联可能反映了压力感受器传入的镇痛作用,其中压力反射功能降低可能导致以纤维肌痛为特征的痛觉过敏。与情感障碍、睡眠问题、