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[心脏X综合征中自主神经系统的活动]

[Activity of the autonomic nervous system in cardiological syndrome X].

作者信息

Kolasińska-Kloch Władysława, Furgała Agata, Kloch Małgorzata, Thor Piotr J

机构信息

II Klinika Kardiologii, Instytut Kardiologii, Collegium Medicum Uniwersytetu Jagiellońskiego, Kraków.

出版信息

Kardiol Pol. 2004 Sep;61 Suppl 2:II96-102.

PMID:20527425
Abstract

BACKGROUND

The etiology of cardiological syndrome X (CSX) is unknown, however the dysfunction of cardiac autonomic nerves has been reported.

AIM

The aim of the study was to evaluate changes in autonomic nervous system (ANS) activity in CSX patients.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

目的

本研究旨在评估CSX患者自主神经系统(ANS)活动的变化。

方法

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。

结果

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。

结论

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。

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