CHARACTERISTICS OF HEMODYNAMICS OF THE SUPERIOR VENA CAVA DURING THE RESPIRATORY CYCLE IN DIFFERENT PROJECTED BODY POSITIONS
Main Article Content
Abstract
Introduction. Studying the effect of respiratory modulation on the haemodynamics of the superior vena cava (SVC) in different body positions makes it possible to reveal the role of the respiratory cycle in venous return of blood to the heart, blood flow dynamics in the vessel, and central haemodynamic reactivity. Inhalation and exhalation, like the projection of the body in space, are powerful regulators of cardiovascular activity. The use of the ultrasound method to assess SVC haemodynamics in different body positions and respiratory phases creates opportunities for in-depth study of the course of physiological processes in normal and pathological conditions.
Objective. The aim of our study was to determine the characteristics of haemodynamics in the superior vena cava of adults using ultrasound Doppler imaging.
Methods of the study. We examined 25 practically healthy volunteers of both sexes aged
19-27 years. We performed ultrasound Doppler assessment of the morphometric parameters of the SVC, functional characteristics of blood flow in the SVC, and parameters of central haemodynamics. Haemodynamics were analysed in different phases of respiration and projection positions (horizontally on the back and supination on the left side) using a Siemens Juniper Acuson (USA) device. The actual data obtained were processed using the method of variational statistics with the Microsoft Excel 2019 software package.
Main results of the study. Significant differences in the morphometric parameters of the SVC recorded in different phases of the respiratory cycle and positions were found. The functional characteristics of the SVC depended on both the diameter of the vessel and its ability to change in accordance with the phases of the respiratory cycle. More noticeable variability in central haemodynamic parameters was found in the supine position. Regardless of the respiratory phase and body position, blood flow in the SVC was characterised by a predominance of systolic peak velocities over diastolic ones. Respiratory modulation of peak velocities manifested itself in the predominance of systolic and diastolic peak velocities in the inspiratory phase over those in the expiratory phase and apnoea.
Scientific novelty of the study results. A tendency towards a decrease in the functional capacity of the right ventricle of the heart was established in the examined patients, who had the lower limit of the norm for the SVC diameter and low peak blood flow velocities during inhalation and exhalation. An inverse relationship was found between SVC and the dominance of the sympathetic division of the autonomic nervous system in the control of cardiac activity.
Conclusions and specific suggestions of the author. The study of morphometric indicators and blood flow velocities in the SVC using ultrasound with Doppler imaging opens up new opportunities for understanding the characteristics of venous haemodynamics in different phases of the respiratory cycle, which will contribute to a deeper understanding of the physiological mechanisms of the cardio-respiratory system and may be useful in the early diagnosis of risks of developing heart failure.
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