Chen Wei-ren, Shi Xiang-min, Yang Ting-shu, Zhao Li-chao, Gao Ling-geng
Department of Cardiology (South Building), PLA General Hospital, Beijing, China.
J Interv Card Electrophysiol. 2013 Apr;36(3):267-72; discussion 272. doi: 10.1007/s10840-012-9728-8. Epub 2012 Nov 20.
Sleep deprivation, which is a strong stressor, can greatly affect the cardiovascular system of rescue workers. This study aimed to investigate the effect of 24-h sleep deprivation on heart rate variability (HRV) in young healthy people and the protective effect of metoprolol on arrhythmia.
Sixty young, healthy subjects (6 women and 54 men), aged 25 ± 4.5 years, were enrolled in this study. All participants received 24-h continuous ambulatory electrocardiogram monitoring. Arrhythmia, time, and frequency domain parameters were analyzed in subjects at the following three stages: normal sleep stage, sleep deprivation stage, and metoprolol treatment before sleep deprivation stage.
After 24-h sleep deprivation, the high frequency (HF) of HRV was significantly decreased (p < 0.05), low frequency (LF) was remarkably increased (p < 0.05), and LF/HF was significantly increased compared with those in normal sleep (p < 0.05). Some subjects presented with mild palpitation due to premature atrial complexes and premature ventricular complexes. At the metoprolol treatment stage, compared with the sleep deprivation stage, LF and LF/HF were significantly reduced, HF of HRV was elevated (p < 0.05), and the total amount of premature atrial and ventricular complexes was decreased.
The underlying mechanism of arrhythmia and HRV alteration after 24-h sleep deprivation could be attributable to lower vagal activity and elevated sympathetic activity. Metoprolol improves the change in autonomic nervous system activity after 24-h sleep deprivation, which may be responsible for its protective role on arrhythmia in healthy subjects undergoing sleep deprivation.
睡眠剥夺作为一种强烈的应激源,会对救援人员的心血管系统产生重大影响。本研究旨在探讨24小时睡眠剥夺对年轻健康人群心率变异性(HRV)的影响以及美托洛尔对心律失常的保护作用。
本研究纳入了60名年龄在25±4.5岁的年轻健康受试者(6名女性和54名男性)。所有参与者均接受24小时动态心电图监测。在以下三个阶段对受试者的心律失常、时域和频域参数进行分析:正常睡眠阶段、睡眠剥夺阶段以及睡眠剥夺前美托洛尔治疗阶段。
24小时睡眠剥夺后,HRV的高频(HF)显著降低(p<0.05),低频(LF)显著升高(p<0.05),且LF/HF与正常睡眠时相比显著增加(p<0.05)。一些受试者因房性早搏和室性早搏出现轻度心悸。在美托洛尔治疗阶段,与睡眠剥夺阶段相比,LF和LF/HF显著降低,HRV的HF升高(p<0.05),房性和室性早搏总数减少。
24小时睡眠剥夺后心律失常和HRV改变的潜在机制可能归因于迷走神经活动降低和交感神经活动增强。美托洛尔改善了24小时睡眠剥夺后自主神经系统活动的变化,这可能是其对睡眠剥夺的健康受试者心律失常具有保护作用的原因。