Nishiue T, Tsuji H, Tokunaga S, Tamura K, Yamamoto Y, Inada M, Iwasaka T
Cardiovascular Center, Kansai Medical University, Osaka, Japan.
Int J Cardiol. 1999 Feb 28;68(2):165-9. doi: 10.1016/s0167-5273(98)00347-7.
Although cigarette smoking is known to be a strong risk factor for the development of coronary artery disease, several large clinical studies have demonstrated that current smokers had a favorable prognosis compared to nonsmokers after myocardial infarction. This study sought to evaluate the effect of smoking status on heart rate variability after onset of acute myocardial infarction. We studied 52 patients (34 smokers, 18 nonsmokers) with a first myocardial infarction within 24 h of onset. We recorded 24-h ambulatory ECG to calculate very low frequency power (VLF), low frequency power (LF) and high frequency power (HF) 14 days after onset. Although smokers had a tendency to be younger than nonsmokers (mean age 57 versus 62, P = 0.0812), clinical characteristics were not statistically different between smokers and nonsmokers. After adjustment for age, left ventricular ejection fraction, history of diabetes, acute revascularization and use of beta-blockers, VLF (P = 0.0183) of smokers 14 days after onset was significantly higher than for nonsmokers. In conclusion, although smoking reduces heart rate variability in the general population, higher heart rate variability was observed in smokers than nonsmokers after acute myocardial infarction under the condition of smoking cessation.
尽管吸烟是已知的冠状动脉疾病发生的一个重要危险因素，但几项大型临床研究表明，与非吸烟者相比，心肌梗死后目前仍在吸烟的患者预后较好。本研究旨在评估吸烟状态对急性心肌梗死后心率变异性的影响。我们研究了52例首次发生心肌梗死且发病时间在24小时内的患者（34例吸烟者，18例非吸烟者）。在发病14天后，我们记录了24小时动态心电图，以计算极低频功率（VLF）、低频功率（LF）和高频功率（HF）。尽管吸烟者的年龄有比非吸烟者小的趋势（平均年龄57岁对62岁，P = 0.0812），但吸烟者和非吸烟者的临床特征在统计学上没有差异。在对年龄、左心室射血分数、糖尿病史、急性血运重建和β受体阻滞剂的使用进行校正后，发病14天后吸烟者的VLF（P = 0.0183）显著高于非吸烟者。总之，尽管吸烟会降低一般人群的心率变异性，但在急性心肌梗死后戒烟的情况下，吸烟者的心率变异性高于非吸烟者。
