Connes Philippe, Martin Cyril, Barthelemy Jean-Claude, Monchanin Géraldine, Atchou Guillaume, Forsuh Anthony, Massarelli Raphaël, Wouassi Dieudonné, Thiriet Patrice, Pichot Vincent
Center of Research and Innovation on Sports, University of Claude Bernard Lyon 1, France.
Clin Physiol Funct Imaging. 2006 Mar;26(2):87-91. doi: 10.1111/j.1475-097X.2006.00655.x.
Sickle cell trait (SCT) is a genetic disease affecting the synthesis of normal haemoglobin (Hb) and marked by the heterozygous presence of HbA and HbS. Some studies have suggested that SCT carriers might be prone to vascular alterations, cardiac ischaemia and arrhythmias leading, in some subjects, to sudden death. It is well known that a loss or a disequilibrium of autonomic activity are powerful predictors of sudden cardiac death. We hypothesized that SCT subjects might exhibit alterations in the activity of the autonomic nervous system that could constitute further risk factors for cardiac complications. Resting haemorheological parameters (eta(b), blood viscosity; eta(p), plasma viscosity; Hct, haematocrit; Tk, red blood cell rigidity), and sympathetic and parasympathetic indices of nocturnal autonomic activity (temporal and frequency analysis of heart rate variability) were thus compared between a group of nine SCT subjects and a group of nine control subjects. eta(b) was higher in the SCT group than in the control group while Hct, eta(p) and Tk were not different. Global variability (SDNN, SDNNIDX) and parasympathetic (PNN50, RMSSD, HF) indices were significantly lower in the SCT group compared with the control group, while the LF/HF ratio was highly increased, underlining a major sympathetic shift. The autonomic imbalance in SCT subjects was mainly related to lowered parasympathetic activity. Thus, our study suggests an additional global decrease and imbalance of autonomic nervous system activity to biological disorders of SCT carriers, that may constitute further risk factors for cardiac complications in this population.
镰状细胞性状（SCT）是一种影响正常血红蛋白（Hb）合成的遗传性疾病，其特征为杂合存在HbA和HbS。一些研究表明，SCT携带者可能易于出现血管改变、心脏缺血和心律失常，在某些个体中会导致猝死。众所周知，自主神经活动的丧失或失衡是心脏性猝死的有力预测指标。我们推测，SCT个体可能表现出自主神经系统活动的改变，这可能构成心脏并发症的进一步危险因素。因此，我们比较了9名SCT受试者和9名对照受试者的静息血液流变学参数（ηb，血液粘度；ηp，血浆粘度；Hct，血细胞比容；Tk，红细胞刚性）以及夜间自主神经活动的交感和副交感指标（心率变异性的时域和频域分析）。SCT组的ηb高于对照组，而Hct、ηp和Tk无差异。与对照组相比，SCT组的整体变异性（SDNN、SDNNIDX）和副交感指标（PNN50、RMSSD、HF）显著降低，而LF/HF比值显著升高，表明交感神经明显占优势。SCT受试者的自主神经失衡主要与副交感神经活动降低有关。因此，我们的数据表明，SCT携带者除了存在生物学紊乱外，自主神经系统活动还存在整体下降和失衡，这可能构成该人群心脏并发症的进一步危险因素。
