Evaluation of arrhythmia scoring systems and exercise-induced cardioprotection.
Evaluation of arrhythmia scoring systems and exercise-induced cardioprotection.
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DOI：
10.1249/mss.0b013e3182323f8b
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发表时间：
2012-03
影响因子：
4.1
通讯作者：
Quindry JC
中科院分区：
文献类型：
--
作者：
Miller LE;Hosick PA;Wrieden J;Hoyt E;Quindry JC
运动可以预防由缺血（I）（血流不足）和再灌注（R）（血流重建）引起的室性心律失常。通过降低心电图异常发生率，可以在临床和科学上观察到这种保护作用。存在许多用于量化室性心律失常严重程度的评分系统。基于室前收缩、室性心动过速和心室颤动频率，这些评分系统旨在提供比个体心律失常变量更稳健的心电图结果指标。评分系统的变化主要取决于数据的连续处理与不连续处理，在将这些心律失常指标与科学应用相匹配时应考虑这一点。本研究的目的是评估七种心电图评分系统，以评估雄性 Sprague-Dawley 大鼠 IR 后室性心律失常的严重程度。在手术诱导 IR 之前，动物保持久坐或运动（3 天的跑步机运动，持续 60 分钟）。一部分久坐的动物作为假动物，在没有红外线的情况下进行外科手术。心电图由三名经过培训的人员在盲法条件下进行评估。单向心律失常数据和参数评分通过单向方差分析进行分析，而 Kruskal-Wallis 则用于比较组间所有非参数评分系统的组平均值。根据所有心律失常评分系统的测定，IR 在运动和久坐的大鼠中产生显着的心律失常反应。四个心律失常指标导致运动治疗和久坐治疗之间存在显着差异（P < 0.001），而三个指标则没有。数据的连续处理与不连续处理可能会导致评分系统结果的变化。这些数据证实，运动可以预防 IR 引起的心律失常，在选择用于心电图评估的心律失常评分系统时必须小心。
Exercise is protective against ventricular arrhythmias induced by ischemia (I), the condition of inadequate blood flow, and reperfusion (R), the reestablishment of blood flow. This protection is observed clinically and scientifically by decreased incidence in ECG abnormalities. Numerous scoring systems exist for the quantification of ventricular arrhythmia severity. On the basis of preventricular contractions, ventricular tachycardia, and ventricular fibrillation frequency, these scoring systems are intended to provide more robust ECG outcome indicators than individual arrhythmia variables. Scoring systems vary primarily on continuous versus discontinuous treatment of the data, which should be considered when matching these arrhythmia metrics to scientific applications. The aim of this investigation was to evaluate seven ECG scoring systems in the assessment of ventricular arrhythmia severity after IR in male Sprague–Dawley rats. Animals remained sedentary or exercised (3 d of treadmill exercise for 60 min) before surgically induced IR. A subset of sedentary animals served as sham, undergoing surgical procedure without IR. ECGs were evaluated under blinded conditions by three trained individuals. Single arrhythmia data and the parametric score were analyzed by one-way ANOVA, whereas the Kruskal–Wallis was used to compare group means for all nonparametric scoring systems between groups. IR produced a significant arrhythmic response in exercised and sedentary rats as determined by all arrhythmia scoring systems. Four arrhythmia metrics resulted in significant differences between exercised and sedentary treatments (P < 0.001), whereas three metrics did not. Continuous versus discontinuous treatment of the data may account for variation in scoring system outcomes. These data confirm that exercise protects against IR-induced arrhythmias, and care must be taken when selecting an arrhythmia scoring system for ECG evaluation.