Evaluation of change in autonomic nervous activity in response to postural change of the upper gastrointestine by X-ray measurement of the heart rate

• Published in: Journal of Gastroenterological Mass Survey Vol. 42; no. 1; pp. 25 - 32
• Main Authors: HAYASHI Toru, NOMURA Masahiro, TORISU Ryusuke, NIKI Miyako, YASUDA Mitugi, KAGOSHIMA Akira, INOUE Hiroyuki, TAKAHASHI Yosinori, YAMANOI Akira, SAKASHITA Osamu, TAKEUCHI Yoshikazu, SAITO Ken, ITO Susumu
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本消化器がん検診学会 2004; The Japanese Society of Gastroenterological Cancer Screening
• Subjects: 心拍変動; 胃X線検査; 自律神経活動
• ISSN: 1345-4110; 2186-7321
• DOI: 10.11404/jsgcs2000.42.1_25

We investigated changes in a utonomic nervous function in response to postural change of the upper gastrointestine by analysis of R-R intervals in electrocardiograms obtained during headup tilt (90°C HUT) and head-down tilt (-35°C HDT). Holter electrocardiograms were obtained from 12 persons at rest (horizontal prone position), during and after HUT and HDT, for frequency-domain analysis of change in the heart rate. During HUT and HDT, the high frequency spectral power (HF power; 0.15 to 0.40Hz), which reflects parasympathetic nervous activity, decreased to significantly less than those at rest or at rest after postural changes (p<0.05). During HUT and HDT, the low frequency spectral power (LF power; 0.04 to 0.15Hz), which reflects the balance of sympathetic and parasympathetic nervous activity, and the LF/HF ratio, which reflects sympathetic nervous activity, increased to significantly more than those at rest or at rest after postural changes (p<0.01). The present study suggests that enhanced sympathetic nervous activity and reduced parasympathetic nervous activity are evoked by postural changes of HUT and HDT. There are reports that enhanced sympathetic activity induces arrhythmias, while enhanced parasympathetic nervous activity has an antiarrhythmic effect. Therefore, we conclude that during upper gastrointestinal movements, a reduced angle or time of postural changes is necessary in elderly people and “highrisk” subjects to prevent cardiovascular complications. 胃X線検査時における体位変換時の自律神経活動の変動を評価するために, 健常成人12人に対し立位時 (90°head-uptilt, 以下HUT) および頭低位時 (-35°head-down tilt, 以下HDT) の心電図R-R間隔を検討した。ホルター心電図を, 安静時25分, 立位または頭低位時5分および再安静時25分間記録し, 心拍変動スペクトル解析を行った。立位および頭低位時のLFpower値およびLF/HF値は, 安静時および再安静時に比べ有意に増加した (p<0.05) 。また立位および頭低位時のHFpower値は, 安静時および再安静時に比べ有意に低下した (p<0.05) 。HUTおよびHDTによる体位変換は, 交感神経活動の亢進および副交感神経活動の低下を引き起こしていると考えられる。交感神経活動の亢進および副交感神経活動の低下の催不整脈作用などが指摘されており, 高齢者や合併症を伴う被験者には, 体位変換時の傾斜角度や時間の軽減などの考慮が必要と考えられた。