Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Dipartimento di Medicina Clinica e Molecolare, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Pacing Clin Electrophysiol. 2020 Oct;43(10):1096-1103. doi: 10.1111/pace.14038. Epub 2020 Aug 29.
BACKGROUND/AIM: Recently, data from temporal dispersion of myocardial repolarization analysis have gained a capital role in the sudden cardiac death risk stratification. Aim of this study was to evaluate the influence of heart rate, autonomic nervous system, and controlled breathing on different myocardial repolarization markers in healthy subjects.
Myocardial repolarization dispersion markers from short-period (5 minutes) electrocardiogram (ECG) analysis (time and frequency domain) have been obtained in 21 healthy volunteers during the following conditions: free breathing (rest); controlled breathing (resp); the first 5 minutes of postexercise recovery phases (exercise ), maximum sympathetic activation; and during the second 5 minutes of postexercise recovery phases (exercise ), intermediate sympathetic activation. Finally, we analyzed the whole repolarization (QTe), the QT peak (QTp), and T peak - T end intervals (Te).
During the exercise , major part of repolarization variables changed in comparison to the rest and resp conditions. Particularly, QTe, QTp, and Te standard deviations (QTe , QTp , and Te ); variability indexes (QTeVI and QTpVI), normalized variances (QTeVN, QTpVN, and TeVN); and the ratio between short-term QTe, QTp, and Te variability RR (STV , STV and STV ) increased. During exercise , QTp (P < .05), QTpVI (P < .05), QTeVN (P < .05), QTpVN (P < .001), TeVN (P < .05), STV (P < .05), STV (P < .001), and STV (P < .001) were significantly higher in comparison to the rest. The slope between QTe (0.24 ± 0.06) or QTp (0.17 ± 0.06) and RR were significantly higher than Te (0.07 ± 0.06, P < .001).
Heart rate and sympathetic activity, obtained during exercise, seem able to influence the time domain markers of myocardial repolarization dispersion in healthy subjects, whereas they do not alter any spectral components.
背景/目的:最近,心肌复极时间离散度分析的数据在心脏性猝死风险分层中发挥了重要作用。本研究旨在评估心率、自主神经系统和控制呼吸对健康受试者不同心肌复极标志物的影响。
在 21 名健康志愿者中,在以下条件下获得了短时间(5 分钟)心电图(ECG)分析(时域和频域)的心肌复极离散标志物:自主呼吸(休息);控制呼吸(呼吸);运动后恢复期的前 5 分钟(运动),最大的交感神经激活;运动后恢复期的后 5 分钟(运动),中等程度的交感神经激活。最后,我们分析了整个复极(QTc)、QT 峰值(QTp)和 T 峰值-终末间期(Te)。
在运动过程中,与休息和呼吸条件相比,大部分复极变量发生了变化。特别是 QTc、QTp 和 Te 的标准差(QTc、QTp 和 Te);变异性指数(QTcVI 和 QTpVI);归一化方差(QTcVN、QTpVN 和 TeVN);以及短时间 QTc、QTp 和 Te 变异性 RR 之间的比值(STV、STV 和 STV)增加。在运动过程中,与休息相比,QTp(P<.05)、QTpVI(P<.05)、QTcVN(P<.05)、QTpVN(P<.001)、TeVN(P<.05)、STV(P<.05)、STV(P<.001)和 STV(P<.001)显著升高。QTc(0.24±0.06)或 QTp(0.17±0.06)与 RR 的斜率明显高于 Te(0.07±0.06,P<.001)。
运动时获得的心率和交感神经活动似乎能够影响健康受试者心肌复极离散的时域标志物,而不会改变任何频谱成分。