Kolasińska-Kloch Władysława, Furgała Agata, Kloch Małgorzata, Thor Piotr J
II Klinika Kardiologii, Instytut Kardiologii, Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków.
Kardiol Pol. 2004 Sep;61 Suppl 2:II96-102.
The etiology of cardiological syndrome X (CSX) is unknown, however the dysfunction of cardiac autonomic nerves has been reported.
The aim of the study was to evaluate changes in autonomic nervous system (ANS) activity in CSX patients.
Forty-three patients (age 48 +/- 9 yrs) with CSX and forty-three healthy volunteers (age 47 +/- 9 yrs) as a control group were included in the study. The function of ANS was assessed using non-invasive methods: heart rate variability (HRV) and tests based on cardiovascular reflexes.
According to HRV analysis the patients were divided into two groups: A--22 pts with decreased HRV parameters and B--18 pts without significant differences as compared with the controls. At rest there was a difference in the HRV parameters between CSX patients and the controls. The CSX patients had the advantage of sympathetic component (the higher ratio LF/HF and LF value). Additionally an increase in heart rate and rate-pressure product was observed in 58% of CSX patients. In CSX patients the 30/15 ratio was decreased in response to changes in the body position in about 45% of CSX patients. A deep breathing test revealed a drop in the Expiration to Inspiration ratio.
In patients with cardiological syndrome X selected tests of ANS indicated the presence of disturbances in the sympathetic-parasympathetic balance. In 40% of CSX patients the response to all autonomic tests was diminished. This indicates that the population of CSX patients is heterogeneous with normal and low abnormal ANS activity.
心脏X综合征(CSX)的病因尚不清楚,但已有报道称存在心脏自主神经功能障碍。
本研究旨在评估CSX患者自主神经系统(ANS)活动的变化。
本研究纳入了43例CSX患者(年龄48±9岁)和43名健康志愿者(年龄47±9岁)作为对照组。采用非侵入性方法评估ANS功能:心率变异性(HRV)和基于心血管反射的测试。
根据HRV分析,患者被分为两组:A组——22例HRV参数降低的患者,B组——18例与对照组相比无显著差异的患者。静息时,CSX患者和对照组的HRV参数存在差异。CSX患者具有交感神经成分优势(更高的LF/HF比值和LF值)。此外,58%的CSX患者观察到心率和心率-压力乘积增加。在CSX患者中,约45%的患者在体位改变时30/15比值降低。深呼吸测试显示呼气与吸气比值下降。
在心脏X综合征患者中,ANS的特定测试表明交感-副交感神经平衡存在紊乱。40%的CSX患者对所有自主神经测试的反应减弱。这表明CSX患者群体具有异质性,ANS活动正常和异常降低。