arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2008-14-1-49-52arthyper-1173Research ArticleКРАТКОЕ СООБЩЕНИЕBRIEF GOMMUNICATIONНеинвазивная оценка чувствительности барорефлексапри беременностиNoninvasiveassessment of spontaneous baroreflex sensitivityin pregnancyГуговаФ.GugovaF.noemail@neicon.ruМамонтовО.MamontovO. V.noemail@neicon.ruБогомоловаО.BogomolovaO.noemail@neicon.ruПетренкоЕ.PetrenkoE. Y.noemail@neicon.ruКонрадиА.KonradiA. O.noemail@neicon.ruФГУ «Федеральный центр сердца, крови и эндокринологии им. В.А. Алмазова Росмедтехнологий», Санкт-ПетербургРоссияAlmazov Federal Heart, Blood, and Endocrinology Center, St.PetersburgRussian FederationГородской родильный дом № 17, Санкт-ПетерубргРоссияAlmazov Federal Heart, Blood, and Endocrinology Center, St.PetersburgRussian Federation2008280220081414952Copyright © Гугова Ф., Мамонтов О.V., Богомолова О., Петренко Е.Y., Конради А.O., 20082008Гугова Ф., Мамонтов О., Богомолова О., Петренко Е., Конради А.Gugova F., Mamontov O.V., Bogomolova O., Petrenko E.Y., Konradi A.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1173

Целью данного исследования было оценить динамику барорефлекторной чувствительности и ее взаимосвязь с гемодинамическими изменениями, возникающими в ранней и поздней стадии беременности, у пациенток с исходно нормальным уровнем артериального давления. В исследование были включены 23 здоровые беременные женщины (средний возраст 27,4+4,4 года), находящиеся на раннем сроке беременности (в пределах 12-14 недель гестации по данным УЗИ). 12 женщин были повторно обследованы на более позднем сроке беременности (26-30 недель). Оценка спонтанной барорефлекторной чувствительности (ЧСБР) осуществлялась с помощью программно-аппаратного комплекса «Finometer» (Голландия). В качестве провокационного теста применялась проба с пассивным ортостазом. На ранних сроках беременности выявлено сохранение, или даже повышение ЧСБР при резком его снижении в ортостазе, что свидетельствует о нарушении адаптивных реакций системы вегетативного обеспечения ортостаза. В дальнейшем ЧСБР незначительно снижалась, но происходило восстановление ортостатической толерантности.

The aim of the present study was to investigate evolution of autonomic function during normal pregnancy without history of hypertension. 23 women of mean age 27,4±4,4 yrs on 12-14 weeks of gestation were examined. Spontaneous baroreflex function (BRS) was analyzed by Finometer device with beat-to-beat blood pressure registration. All measurements were performed at supine rest and 5 minute passive tilt (70). Baroreflex was calculated by sequence technique. 12 women were studies second time on 26-30 week of pregnancy. A normal or increases values of spontaneous baroreflex were observed in early pregnancy with e significant reduction of baroreflex sensitivity during tilt. In late pregnancy restoration of the orthostatic tolerance was accompanied by decrease of BRS.

беременностьбарорефлекспассивный ортостазpregnancyspontaneous baroreflexbeat-to-bear blood pressurepassive tiltReferencesBeilin L.J. Hypertension research in the 21st century: where is the gold? J Hypertension 2004; 22; 2243-2251.Beilin L.J. Hypertension research in the 21st century: where is the gold? J Hypertension 2004; 22; 2243-2251.Schobel H.P., Fischer T., Heuszer K., Geiger H., Schmieder R.E.Preeclampsia - a state of sympathetic overactivity. N Engl J Med.1996;14;335:1480-1485.Schobel H.P., Fischer T., Heuszer K., Geiger H., Schmieder R.E.Preeclampsia - a state of sympathetic overactivity. N Engl J Med.1996;14;335:1480-1485.Ganzevoort W., Rep A., Bonsel G.J., de Vries J.I., Wolf H. Plasma volume and blood pressure regulation in hypertensive pregnancy. J Hypertens. 2004;22(7): 1235-1242Ganzevoort W., Rep A., Bonsel G.J., de Vries J.I., Wolf H. Plasma volume and blood pressure regulation in hypertensive pregnancy. J Hypertens. 2004;22(7): 1235-1242Greenwood J.P., Stoker J.B., Walker J.J., Mary D.A. Sympathetic nerve discharge in normal pregnancy and pregnancy-induced hypertension. J Hypertens. 1998;16(5):617-624.Greenwood J.P., Stoker J.B., Walker J.J., Mary D.A. Sympathetic nerve discharge in normal pregnancy and pregnancy-induced hypertension. J Hypertens. 1998;16(5):617-624.van de Borne P., Montano N., Zimmerman B., Pagani M., SomersV.K. Relationship between repeated measures of hemodynamics, musclesympathetic nerve activity, and their spectral oscillations. Circulation.1997;96:4326-4332.van de Borne P., Montano N., Zimmerman B., Pagani M., SomersV.K. Relationship between repeated measures of hemodynamics, musclesympathetic nerve activity, and their spectral oscillations. Circulation.1997;96:4326-4332.Pagani M., Montano N., Porta A., Malliani A., Abboud F.M.,Birkett C., Somers V.K.. Relationship between spectral components ofcardiovascular variabilities and direct measures of muscle sympatheticnerve activity in humans. Circulation. 1997;95(6): 1441-1448.Pagani M., Montano N., Porta A., Malliani A., Abboud F.M.,Birkett C., Somers V.K.. Relationship between spectral components ofcardiovascular variabilities and direct measures of muscle sympatheticnerve activity in humans. Circulation. 1997;95(6): 1441-1448.Rang S., Wolf H., Montfrans G.A., Karemaker J.M. Non-invasiveassessment of autonomic cardiovascular control in normal humanpregnancy and pregnancy- associated hypertensive disorders: a review.J Hypertens. 2002;20:2111-2119.Rang S., Wolf H., Montfrans G.A., Karemaker J.M. Non-invasiveassessment of autonomic cardiovascular control in normal humanpregnancy and pregnancy- associated hypertensive disorders: a review.J Hypertens. 2002;20:2111-2119.Souma M.L., Cabaniss C.D., Nataraj A., Khan Z. The Valsalvamaneuver: a test of autonomic nervous system function in pregnancy.Am J Obstet Gynecol. 1983;145(3):274-278.Souma M.L., Cabaniss C.D., Nataraj A., Khan Z. The Valsalvamaneuver: a test of autonomic nervous system function in pregnancy.Am J Obstet Gynecol. 1983;145(3):274-278.Lucini D., Strappazzon P., Vecchia L.D., Maggioni C., Pagani M.Cardiac autonomic adjustments to normal human pregnancy: insightfrom spectral analysis of R-R interval and systolic arterial pressurevariability. J Hypertens. 1999;17(12 Pt 2): 1899-1904.Lucini D., Strappazzon P., Vecchia L.D., Maggioni C., Pagani M.Cardiac autonomic adjustments to normal human pregnancy: insightfrom spectral analysis of R-R interval and systolic arterial pressurevariability. J Hypertens. 1999;17(12 Pt 2): 1899-1904.Penaz J. Photoelectric measurement of blood pressure, volume and flow in the finger. Digest 10th Int Conf Med Biol Eng. 104. Dresden, Germany, 1973.Penaz J. Photoelectric measurement of blood pressure, volume and flow in the finger. Digest 10th Int Conf Med Biol Eng. 104. Dresden, Germany, 1973.Wesserling K.H. A century of noninvasive arterial pressure measurement: from Marey to Panaz and Finapress. Homeostssis 1995; 36:50-66.Wesserling K.H. A century of noninvasive arterial pressure measurement: from Marey to Panaz and Finapress. Homeostssis 1995; 36:50-66.Barron W.M., Mujais S.K., Zinaman M., Bravo E.L., Lindheimer M.D. Plasma catecholamine responses to physiologic stimuli in normalhuman pregnancy. Am J Obstet Gynecol. 1986;154:80-84.Barron W.M., Mujais S.K., Zinaman M., Bravo E.L., Lindheimer M.D. Plasma catecholamine responses to physiologic stimuli in normalhuman pregnancy. Am J Obstet Gynecol. 1986;154:80-84.Lipman R.D., Salisbury J.Y., Taylor A. Sponteneus indicesare inconsistent with arterial baroreflex gain. Hypertension 2003;42:481-487.Lipman R.D., Salisbury J.Y., Taylor A. Sponteneus indicesare inconsistent with arterial baroreflex gain. Hypertension 2003;42:481-487.Ekholm E.M., Erkkola R.U. Autonomic cardiovascular control inpregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;64:29-36.Ekholm E.M., Erkkola R.U. Autonomic cardiovascular control inpregnancy. Eur J Obstet Gynecol Reprod Biol. 1996;64:29-36.Ekholm E.M., Erkkola R.U., Piha S.J., Jalonen J.O., Меtsдlд Т.Н.,Antila K.J. Changes in autonomic cardiovascular control in midpregnancy.: Clin Physiol. 1992;12:527-536.Ekholm E.M., Erkkola R.U., Piha S.J., Jalonen J.O., Меtsдlд Т.Н.,Antila K.J. Changes in autonomic cardiovascular control in midpregnancy.: Clin Physiol. 1992;12:527-536.Cohen W.R., Galen L.H., Vega-Rich M., Young J.B. Cardiac sympathetic activity during rat pregnancy. Metabolism. 1988 Aug;37(8):771-777.Cohen W.R., Galen L.H., Vega-Rich M., Young J.B. Cardiac sympathetic activity during rat pregnancy. Metabolism. 1988 Aug;37(8):771-777.Quesnell R.R., Brooks V.L. Alterations in the baroreflex occur late in pregnancy in conscious rabbits. Am J Obstet Gynecol. 1997 Mar;176(3):692-694.Quesnell R.R., Brooks V.L. Alterations in the baroreflex occur late in pregnancy in conscious rabbits. Am J Obstet Gynecol. 1997 Mar;176(3):692-694.Brooks V.L., Keil L.C. Changes in the baroreflex during pregnancy in conscious dogs: heart rate and hormonal responses. Endocrinology. 1994Nov;135(5):1894-1901Brooks V.L., Keil L.C. Changes in the baroreflex during pregnancy in conscious dogs: heart rate and hormonal responses. Endocrinology. 1994Nov;135(5):1894-1901Brooks V.L., Kane C.M., Van Winkle D.M. Altered heart rate baroreflex during pregnancy: role of sympathetic and parasympathetic nervous systems. Am J Physiol. 1997 Sep;273(3 Pt 2):R960-R966.Brooks V.L., Kane C.M., Van Winkle D.M. Altered heart rate baroreflex during pregnancy: role of sympathetic and parasympathetic nervous systems. Am J Physiol. 1997 Sep;273(3 Pt 2):R960-R966.Leduc L., Wasserstrum N., Spillman T., Cotton D.B. Baroreflex function in normal pregnancy. Am J Obstet Gynecol. 1991 Oct; 165 (4 Pt l):886-890.Leduc L., Wasserstrum N., Spillman T., Cotton D.B. Baroreflex function in normal pregnancy. Am J Obstet Gynecol. 1991 Oct; 165 (4 Pt l):886-890.

The authors declare that there are no conflicts of interest present.