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美托洛尔对24小时睡眠剥夺的健康人群心律失常及心率变异性的保护作用

Protective effect of metoprolol on arrhythmia and heart rate variability in healthy people with 24 hours of sleep deprivation.

作者信息

Chen Wei-ren, Shi Xiang-min, Yang Ting-shu, Zhao Li-chao, Gao Ling-geng

机构信息

Department of Cardiology (South Building), PLA General Hospital, Beijing, China.

出版信息

J Interv Card Electrophysiol. 2013 Apr;36(3):267-72; discussion 272. doi: 10.1007/s10840-012-9728-8. Epub 2012 Nov 20.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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