Interrelation of heart rate and autonomic activity in asymptomatic men with unobstructed coronary arteries. Studies with atrial pacing, adrenaline infusion, and autonomic blockade.
Interrelation of heart rate and autonomic activity in asymptomatic men with unobstructed coronary arteries. Studies with atrial pacing, adrenaline infusion, and autonomic blockade.
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冠状动脉畅通的无症状男性心率与自主活动的相互关系。
DOI：
10.1136/hrt.47.1.19
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发表时间：
1982
影响因子：
--
通讯作者：
J. White
中科院分区：
文献类型：
--
作者：
P. Taggart;R. Donaldson;J. Green;S. Joseph;H. Kelly;J. Marcomichelakis;D. Noble;J. White
总结 我们对静息心电图异常的无症状男性进行了观察，这些男性的变化与心肌缺血的变化难以区分，但冠状动脉造影正常。在本研究中，我们的目的是将心率的影响与交感神经系统的影响分开。因此，我们研究了单独心房起搏、起搏和肾上腺素输注相结合、β-阻滞后起搏以及β-阻滞加阿托品后起搏的效果。对 20 名年龄在 17 岁至 57 岁之间的无症状男性进行了调查。所有患者的冠状动脉均无阻塞，左心室血管造影正常。超声心动图检查结果正常。十六个在侧导联中具有平坦或倒置的 T 波（指定为“T”），两个具有 ST 压低（指定为“ST”），两个具有混合模式。 T 波异常以及较小程度的 ST 变化在医院休息过夜后恢复正常或消退。随后心房起搏至 160 次/分钟再现或增加了相应的异常。当肾上腺素以低剂量输注，足以对 ST-T 段产生明显的影响（每分钟 0-024 至 0*091 ug/kg）并重复心房起搏时，后者的效果增强。肾上腺素和起搏都以相同方向影响 ST-T 段。静脉注射普萘洛尔（0.2 mg/kg）可阻断肾上腺素的作用及其与起搏的协同作用，但对单独起搏的效果几乎没有影响。心得安（0.04 mg/kg）后静脉给予阿托品可降低心房效应
suMMARY We have extended our observations on asymptomatic men with abnormal resting electrocardiograms showing changes indistinguishable from those of myocardial ischaemia but with normal coronary arteriograms. In the present investigation we aimed to separate the effects of heart rate alone from those of the sympathetic nervous system. We therefore studied the effects of atrial pacing alone, pacing and adrenaline infusion combined, pacing after beta-blockade, and pacing after beta-blockade plus atropine. Twenty asymptomatic men, aged 17 to 57, were investigated. All were shown to have unob-structed coronary arteries and normal left ventricular angiograms. Echocardiographic findings were normal. Sixteen had flat or inverted T waves in the lateral leads (designated "T"), two had ST depression (designated "ST"), and two had mixed patterns. T wave abnormalities and, to a lesser extent, ST changes returned to normal or regressed after an overnight rest in hospital. Subsequent atrial pacing to 160/minute reproduced or increased the respective abnormalities. When adrenaline was infused in low doses just sufficient to produce discernible effects on the ST-T segment (between 0-024 and 0*091 ,ug/kg per min) and atrial pacing was repeated, the effect of the latter was enhanced. Both adrenaline and pacing influenced the ST-T segment in the same direction. Intravenous propranolol (0.2 mg/kg) blocked the effect of adrenaline and its synergistic effect with pacing but exerted little if any influence on the effect of pacing alone. Atropine given intravenously after propranolol (0.04 mg/kg) reduced the effect of atrial