Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana; Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indianapolis, Indiana.
Heart Rhythm. 2021 Dec;18(12):2169-2176. doi: 10.1016/j.hrthm.2021.08.031. Epub 2021 Sep 2.
Exercise stress testing is frequently used to expose cardiac arrhythmias. Aerobic exercise conditioning has been used as a nonpharmacologic antiarrhythmic intervention.
The purpose of this study was to test the hypothesis that noninvasively recorded skin sympathetic nerve activity (SKNA) is increased during exercise and that SKNA response varies according to fitness levels.
Oxygen consumption (VO) and SKNA were recorded in 39 patients undergoing an incremental exercise test. Patients were grouped by 5 levels of fitness based on age, sex, and VOmax.
With exercise, all patients had a significant increase in average SKNA (aSKNA) (1.58 ± 1.12 μV to 4.50 ± 3.06 μV, P = .000) and heart rate (HR) (87.40 ± 20.42 bpm to 154.13 ± 16.82 bpm, P = .000). A mixed linear model of aSKNA was used with fixed effects of fitness, exercise time, and recovery time, and random effects of subject level intercept and slopes for exercise time and recovery times. The poor fitness group had significantly higher aSKNA than the other groups (P = .0273). For all subjects studied, aSKNA increased by 5% per minute with progression of exercise and decreased by 15% per minute with progression of recovery. The fitness variable encodes information on both comorbidities and body mass index (BMI). Once fitness level is known, comorbidities and BMI are not significantly associated with aSKNA. In all groups, aSKNA positively correlated with HR (R = 0.47 ± 0.23) and VO (R = 0.68 ± 0.25).
Fitness level determines the magnitude and time course of SKNA increase during exercise. SKNA may be a useful fitness biomarker in exercise stress testing.
运动应激测试常用于暴露心脏心律失常。有氧运动训练已被用作非药物抗心律失常干预。
本研究旨在检验以下假说，即非侵入性记录的皮肤交感神经活动（SKNA）在运动过程中增加，并且 SKNA 反应根据健康水平而变化。
在 39 名接受递增运动测试的患者中记录耗氧量（VO）和 SKNA。根据年龄、性别和 VOmax 将患者分为 5 个健康水平组。
随着运动，所有患者的平均 SKNA（aSKNA）均显著增加（1.58 ± 1.12 μV 至 4.50 ± 3.06 μV，P =.000）和心率（HR）（87.40 ± 20.42 bpm 至 154.13 ± 16.82 bpm，P =.000）。aSKNA 的混合线性模型采用固定效应为健康水平、运动时间和恢复时间，以及随机效应为个体水平截距和运动时间和恢复时间的斜率。健康水平较差的组的 aSKNA 显著高于其他组（P =.0273）。对于所有研究对象，aSKNA 随运动进展每分钟增加 5%，随恢复进展每分钟减少 15%。健康变量编码了合并症和体重指数（BMI）的信息。一旦知道了健康水平，合并症和 BMI 与 aSKNA 就没有显著关联。在所有组中，aSKNA 与 HR（R = 0.47 ± 0.23）和 VO（R = 0.68 ± 0.25）呈正相关。
健康水平决定了运动过程中 SKNA 增加的幅度和时程。SKNA 可能是运动应激测试中有用的健康生物标志物。
