EXERCISE-INDUCED CARDIAC ARRHYTHMIAS

运动引起的心律失常

• 批准号: 3821450
• 负责人: J L FLEG
• 金额: --
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3821450
• 关键词: aging; angina pectoris; arrhythmia; blood pressure; bradycardia; cardiovascular disorder epidemiology; cardiovascular stress test; electrocardiography; heart disorder diagnosis; heart rate; human middle age (35-64); human old age (65+); human subject; hypotension; longitudinal human study; myocardial infarction; myocardial ischemia /hypoxia; stress; sudden cardiac death; syncope; tachycardia

We compared the prevalence and complexity of exercise-induced arrhythmias in BLSA subjects on chronic diuretic monotherapy of hypertension with that in normotensive control group. Although the prevalence of exercise induced arrhythmias was higher in the diuretic treated group (D) that in controls (C) 57% vs 38%, p less than .05, this difference was due entirely to the high prevalence of simple ventricular ectopic beats (VEB): 44% versus 26%, p less than .05. No difference between the groups was found in the prevalence of frequent or complex ectopic beats. Between 1974 and 1984, 80 BLSA subjects (6.9% of those tested), developed frequent (more than 10% of beats in any minute) ventricular ectopic beats (VEB) or runs of 3 or more VEB on at least one maximal treadmill exercise test. Those developing frequent or repetitive VEB were older than the remaining subjects 63.8 plus/minus 12.5 vs 50.0 plus/minus 16.1 yr, p less than .0001. Within the former group, an ischemic ST segment response to exercise was observed in only 11%. Over a mean follow-up period of 4.6 years without anti-arrhythmic drug therapy, only one cardiac death and one non-fatal myocardial infarction have occurred. To investigate the mechanisms for exercise-induced complex ventricular arrhythmias in apparently healthy subjects, we compared repolarization time, i.e QT intervals, in 20 BLSA subjects with exercise induced nonsustained ventricular tachycardia (VT) with those of 20 normal BLSA individuals matched for age and sex, who were free of exercise-induced arrhythmias. Although no difference in heart rate was present at rest or at maximal effort between groups, those with exercise- induced VT had longer QT intervals then the controls (278 plus/minus 9 vs 259 plus/minus 6 msec, p less than .08). Whereas 12 of 20 VT subjects failed to shorten their QT interval by 25% only 5 of 20 controls demonstrated this finding, p less than .05. (Formerly: Complication of Maximal treadmill Exercise in Apparently Normal Subjects)

我们比较了运动引起的疾病的患病率和复杂性 接受慢性利尿剂单药治疗的BLSA受试者中的心律失常 高血压组与正常血压对照组比较。 虽然 运动诱发心律失常的患病率在 利尿剂治疗组（D）57%比对照组（C）38%，P <0.05 0.05，这种差异完全是由于高患病率 单纯性室性异位搏动（VEB）：44%对26%，P <0.05。 比0.05 两组之间在以下方面无差异： 频繁或复杂的异位搏动的患病率。 1974年至1984年，80名BLSA受试者（占受试者的6.9%）， 出现频繁心跳（任何一分钟内超过10%的心跳） 室性异位搏动（VEB）或连续3次或3次以上VEB， 至少一次最大跑步机运动试验。 这些发展中 频繁或重复性VEB的年龄大于其余受试者 63.8± 12.5 vs 50.0 ± 16.1年，p <0.0001。 在前一组中，缺血性ST段反应， 只有11%的人进行了锻炼。 平均随访期内 4.6年没有抗疟疾药物治疗，只有一个 心源性死亡和一例非致命性心肌梗死， 发生了。 探讨运动性心肌损伤的机制 在表面健康的受试者中， 我们比较了20例BLSA患者的复极时间，即QT间期， 受试者运动诱发非持续性心室 20例BLSA正常人心动过速（VT） 年龄和性别相匹配，无运动诱发的 心律不齐 虽然心率没有差异， 休息或在最大努力组之间，那些与运动- 诱发VT的QT间期较对照组长（278 加/减9对259加/减6毫秒，p小于0.08）。 而 20例VT受试者中有12例QT间期未能缩短25% 20个对照组中只有5个证明了这一发现，p小于0.05。 （原：最大跑步机运动的并发症， （正常人）