Abstract

Changes in cardiac rhythm are not the only determinants of blood pressure variations in man. They play a part in the variations of systolic and diastolic pressures, the relative importance of which depends on the degree of arhythmia present and on the depth of respiration which, in itself, causes the systolic and diastolic pressures to decrease during inspiration and increase during expiration. No degree of rate variation can be regarded as a type. The cases range from those in which respiration governs the change of pressures entirely through those where more or less complicated mixtures of heart rate and respiratory influences intermingle to those in which extreme cardiac variations alone determine the pressure changes. The emphatic insistence of Henderson and his collaborators that heart rate changes play a more important part than is commonly recognized in man is true in many cases. That, in certain cases, it is the only determining influence may also be admitted, but they are in the minority. The majority show the intervention of a respiratory influence which controls, at least, the variations of systolic pressure. In the light of these results, the doctrine that, in man, an effective venous pressure exists sufficient during all respiratory phases to insure superimposable beats, must be subjected to further reinvestigation.

Highlights

  • The observation that blood pressure undergoes periodic variations with inspiration and expiration dates from the experiments of Stephen Hales (I) in 1733

  • With a progressive decrease of the cardiac cycle we find a decrease in systolic and an increase in diastolic pressure

  • Changes in cardiac rhythm are not the only determinants of blood pressure variations in man. They play a part in the variations of systolic and diastolic pressures, the relative importance of which depends on the degree of arhythmia present and on the depth of respiration which, in itself, causes the systolic and diastolic pressures to decrease during inspiration and increase during expiration

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Summary

INTRODUCTION

The observation that blood pressure undergoes periodic variations with inspiration and expiration dates from the experiments of Stephen Hales (I) in 1733. Ludwig (2) observed these variations, placed the time of acceleration in the expiratory period, and disregarded its possible significance in the causation of pressure variations It was held in similar disregard by Magendie (3), as well as by Donders (4). Burden-Sanderson (6) confirmed the observation that the heart rate increased during inspiration He believed that the enlargement of the thorax caused a belated expansion of-the veins and the relaxing heart, which favored their filling. Fredericq (I2)demonstrated that probably these variations were dependent on a central influence and clearly analyzed the part they played in respiratory variations of blood pressure He pointed out that variations of blood pressure occurred in the dog with respiratory phases, whether the heart was rhythmic or arhythmic. There was this difference: in the former case blood pressure fell

Does Cardiac Rhythm Determine Blood Pressure Variations?
14 Does Cardgac Rhythm Determine Blood Pressure Variations?
CONCLUSIONS
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