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通过心率变异性评估的心脏自主神经调制在不确定型恰加斯病中未发生改变,但存在细微的广泛变化。

Cardiac autonomic modulation evaluated by heart interval variability is unaltered but subtly widespread in the indeterminate Chagas' disease.

作者信息

Correia Dalmo, Junqueira Luiz Fernando, Molina Rodrigo Juliano, Prata Aluízio

机构信息

Faculty of Medicine of Triângulo Mineiro, Division of Tropical Medicine, Uberaba, MG, Brazil.

出版信息

Pacing Clin Electrophysiol. 2007 Jun;30(6):772-80. doi: 10.1111/j.1540-8159.2007.00749.x.

Abstract

BACKGROUND

Cardiac autonomic function in the indeterminate chronic form of Chagas' disease deserves better clearing-up and understanding, since the existing findings are scarce and controversial. This work analyzed the short-term heart interval variability in order to verify the cardiac autonomic modulation in indeterminate Chagas' disease subjects examined in a Brazilian endemic area.

METHODS

Variability in time and frequency domain of 5-minute electrocardiogram (ECG) series of R-R intervals in supine and active standing positions were obtained from 18 age-, gender-, body mass index-, lifestyle-, and physical activity-matched chagasics and 18 control healthy subjects examined in Agua Comprida city, MG, Brazil. Mann-Whitney test was used for analysis of the data and spread of the individual indices in both groups.

RESULTS

The median of the all variability indices in the chagasic group were statistically similar (P= 0.17-0.87) to that in the control group. A wide dispersion of the almost all individual indices values, ranging from normal to variably reduced or increased ones, was noted in the majority of the chagasics in relation to the control interquartile range, in both postural positions.

CONCLUSION

As a group, indeterminate Chagas' disease subjects showed unaltered short-term heart interval variability. Individual somewhat widespread of majority of time- and frequency-domain indices, from depressed to exacerbated ones appears to exist. This conforms to a variable cardiac autonomic modulation in this form of disease, suggesting that the majority of chagasics has no lesions, and a minority has subtle lesions of the efferent innervation-sinus node complex.

摘要

背景

恰加斯病不确定的慢性形式中的心脏自主神经功能值得更深入的研究和理解,因为现有的研究结果稀少且存在争议。本研究分析了短期心率变异性,以验证巴西流行地区检测的不确定型恰加斯病患者的心脏自主神经调节情况。

方法

从巴西米纳斯吉拉斯州阿瓜孔普里达市检测的18名年龄、性别、体重指数、生活方式和身体活动相匹配的恰加斯病患者以及18名对照健康受试者中,获取仰卧位和主动站立位5分钟心电图(ECG)系列R-R间期的时域和频域变异性。采用曼-惠特尼检验分析两组数据及各指标分布情况。

结果

恰加斯病组所有变异性指标的中位数与对照组在统计学上相似(P = 0.17 - 0.87)。在两种体位下,与对照组四分位间距相比,大多数恰加斯病患者几乎所有个体指标值分布广泛,从正常到不同程度降低或升高。

结论

总体而言,不确定型恰加斯病患者短期心率变异性未改变。大多数时域和频域指标在个体中分布较为分散,从降低到增强均有。这符合这种疾病形式下可变的心脏自主神经调节,提示大多数恰加斯病患者无病变,少数患者存在传出神经-窦房结复合体的细微病变。

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