HEART-RATE-VARIABILITY AS AN INDEX OF SYMPATHOVAGAL INTERACTION AFTER ACUTE MYOCARDIAL-INFARCTION
HEART-RATE-VARIABILITY AS AN INDEX OF SYMPATHOVAGAL INTERACTION AFTER ACUTE MYOCARDIAL-INFARCTION
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DOI：
10.1016/0002-9149(87)90601-1
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发表时间：
1987-12-01
影响因子：
2.8
通讯作者：
MALLIANI, A
中科院分区：
文献类型：
--
作者：
LOMBARDI, F;SANDRONE, G;MALLIANI, A
通过分析心率变异性的频谱成分，评价急性心肌梗死（AMI）后交感迷走神经相互作用。在AMI后2周（n = 70），低频成分显著更大（69 . ±. 2比53 +-。3个标准化单位[NU]，p < 0.05），高频成分显著较小（17 . ±. 1比35 +-。3NU）。这种差异可能反映了交感神经活性占主导地位的交感迷走神经调节流出的改变。在AMI后6个月（n = 33）和12个月（n = 29），低-（62 . ±. 2和54 .+-。3 NU）和高频（23 .+-. 2和30。+-。2 NU）频谱成分，提示交感迷走神经相互作用正常化。由倾斜引起的交感传出活动的增加并没有进一步改变低频频谱成分（78 . ±. 3比74 +-。3 NU）。相反，在AMI后1年，这种操作伴随着低频成分的增加（77 ± 1.5%）。3比53 +-。3 NU，p < 0.05），其量级类似于在对照受试者中观察到的量级（78 . ±. 3比53 +-。3个NU。这些数据表明，在AMI后2周可检测到的交感神经优势之后是迷走神经张力的恢复和交感神经迷走神经相互作用的正常化，不仅在静息条件下，而且在对交感神经刺激的响应中。
By analysis of spectral components of heart rate variability, sympathovagal interaction was assessed in patients after acute myocardial infarction (AMI). At 2 weeks after AMI (n = 70), the low-frequency component was significantly greater (69 .+-. 2 vs 53 .+-. 3 normalized units [NU], p < 0.05) and the high frequency component was significantly smaller (17 .+-. 1 vs 35 .+-. 3 NU) than in 26 age-matched control subjects. This difference was likely to reflect an alteration of sympathovagal regulatory outflows with a predominance of sympathetic activity. At 6 (n = 33) and 12 (n = 29) months after AMI, a progressive decrease in the low- (62 .+-. 2 and 54 .+-. 3 NU) and an increase in the high-frequency (23 .+-. 2 and 30 .+-. 2 NU) spectral components was observed, which suggested a normalization of sympathovagal interaction. An increase in sympathetic efferent activity induced by tilt did not further modify the low-frequency spectral component (78 .+-. 3 vs 74 .+-. 3 NU) in a subgroup of 24 patients at 2 weeks after AMI. Instead, 1 year after AMI, this maneuver was accompanied by an increase in the low-frequency component (77 .+-. 3 vs 53 .+-. 3 NU, p < 0.05) of a magnitude similar to the one observed in control subjects (78 .+-. 3 vs 53 .+-. 3 NU. These data indicate that the sympathetic predominance that is detectable 2 weeks after AMI is followed by recovery of vagal tone and a normalization of sympathovagal interaction, not only during resting conditions, but also in response to a sympathetic stimulus.