Effects of cardiac rehabilitation and beta-blocker therapy on heart rate variability after first acute myocardial infarction
Effects of cardiac rehabilitation and beta-blocker therapy on heart rate variability after first acute myocardial infarction
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DOI：
10.1016/s0002-9149(98)00021-6
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发表时间：
1998-04-01
影响因子：
2.8
通讯作者：
Leonetti, G
中科院分区：
文献类型：
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作者：
Malfatto, G;Facchini, M;Leonetti, G
急性心肌梗死(AMI)后，康复配合体育锻炼可增加副交感神经张力。目前尚不清楚锻炼对交感迷走神经平衡的有利影响是否与其他广泛使用的疗法(如β受体阻滞剂)的效果相互作用。在53例首次无并发症的急性心肌梗死患者中，我们研究了康复和β-受体阻滞剂对心率变异性(HRV)的短期和长期影响。将患者分为3组：第1组(n=19)接受康复训练，第2组(n=20)服用β-受体阻滞剂并接受康复治疗，第3组(n=14)服用β-受体阻滞剂，因逻辑原因不参加康复计划。患者在年龄、梗死部位、射血分数、左心室内径和基线负荷试验持续时间方面相似。心率变异的测量(从15分钟静息心电图获得)是平均RR间期的标准差(RRSD)、均方连续差(MSSD)、RR间期与前一个RR间期相差50ms的百分比(PNN50)、RR间期自回归功率谱的低频(LF)和高频(HF)分量及其比率(LF/HF)。在急性心肌梗死后4周，第2组和第3组(即服用β受体阻滞剂的患者)交感神经优势较少[p
After acute myocardial infarction (AMI), rehabilitation with physical training increases parasympathetic tone. It is unknown whether such a favorable effect of exercise on the sympathovagal balance interacts with effects of other widespread therapies, such as beta blockers. In 53 patients after a first, uncomplicated AMI, we studied the combined short- and long-term influence on heart rate variability (HRV) of rehabilitation and beta blockade. Patients were divided into 3 groups: group 1 (n = 19) underwent rehabilitation with physical training; group 2 (n = 20) was taking beta blockers and underwent rehabilitation; group 3 (n = 14) was taking beta blockers and did not enter the rehabilitation program for logistic reasons. Patients were similar as to age, site of infarction, ejection fraction, left ventricular diameter, and baseline stress test duration. Measures of HRV (obtained from a 15-minute resting electrocardiogram) were the standard deviation of the mean RR interval (RRSD), the mean squared successive differences (MSSD), the percent of RR intervals differing >50 ms from the preceding one (pNN50), the low-(LF) and high-(HF) frequency components of the autoregressive power spectrum of the RR intervals and their ratio (LF/HF). Four weeks after AMI, there was less sympathetic predominance in groups 2 and 3 (i.e., patients taking beta blockers [p