Sympathoadrenal and cardiovascular responses to mental stress, isometric handgrip, and cold pressor test in asymptomatic young men with primary T wave abnormalities in the electrocardiogram.
Sympathoadrenal and cardiovascular responses to mental stress, isometric handgrip, and cold pressor test in asymptomatic young men with primary T wave abnormalities in the electrocardiogram.
复制标题
心电图原发性 T 波异常的无症状年轻男性对精神压力、等长握力和冷加压试验的交感肾上腺和心血管反应。
作者：
JAN;Keith Eliasson;Paul Hjemdahl
通过测定12名心电图原发性T波异常且无心脏病史或体征的年轻无症状男性（T组）和13名匹配对照者在静息和应激激发时的血浆儿茶酚胺，评价交感肾上腺活性。T波异常包括II、V4和V6导联的切迹、变平或倒置，无伴发ST段压低。在休息时，血浆去甲肾上腺素是约2倍高，在T组的控制，而血浆肾上腺素和多巴胺水平在两组相似。无创血流动力学监测（血压和心阻抗图）显示T组收缩压和心阻抗显著升高，心肌收缩力增加，无心动过速。一个标准化的精神压力测试，等长的手握，冷加压试验都显着增加血压，以及去甲肾上腺素和肾上腺素在两组。舒张压和肾上腺素的增加往往是较大的T组与紧张的挑衅，表明增加交感肾上腺反应。收缩压和去甲肾上腺素的增加在刺激期间持续存在。在这两组中，冷加压试验主要通过血管收缩来升高血压，增加去甲肾上腺素的程度高于其他两项试验，后者被认为主要通过心脏刺激来起作用。由于发现肾上腺素水平较低，神经机制似乎比肾上腺素对这些刺激的循环反应更重要。这项研究提供的证据支持在休息时增加交感神经活动和在应激期间增强交感肾上腺反应性
SUMMARY Sympathoadrenal activity was evaluated by the determination of plasma catecholamines at rest and during stressful provocations in 12 young asymptomatic men with primary T wave abnormalities in the electrocardiogram and without a history or signs of cardiac disease (group T) and in 13 matched controls. The T wave abnormalities consisted of notching, flattening, or inversion without concomitant ST depression in leads II, V4, and V6. At rest, plasma noradrenaline was approximately twice as high in group T as in the controls, whereas plasma adrenaline and dopamine levels were similar in the two groups. Non-invasive haemodynamic monitoring (blood pressure and impedance cardiography) showed a significantly higher systolic blood pressure and impedance signs of increased cardiac contractility without tachycardia in group T. A standardised mental stress test, isometric hand grip, and a cold pressor test all significantly increased blood pressure, as well as noradrenaline and adrenaline in both groups. The increases in diastolic blood pressure and adrenaline tended to be larger in group T in connection with stressful provocations, indicating increased sympathoadrenal reactivity. The increases in systolic blood pressure and noradrenaline persisted during provocations. In both groups the cold pressor test, which raises blood pressure mainly by vasoconstriction, increased noradrenaline more than did the other two tests, which are believed to act mainly by cardiac stimulation. Because of the low adrenaline levels found, neurogenic mechanisms appear to be of greater importance than adrenaline for the circulatory responses to each of these provocations. The study provides evidence in favour of increased sympathetic activity at rest and enhanced sympathoadrenal reactivity during stress