Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Via Pergolesi 33, 20052, Monza, Italy.
Acta Diabetol. 2022 Nov;59(11):1429-1435. doi: 10.1007/s00592-022-01945-5. Epub 2022 Jul 29.
We examined whether to what extent resting heart rate (HR) values are capable to reflect in the metabolic syndrome (MS) a different degree of sympathetic activation. We also thought to determine at which HR cutoff values the sympathetic nervous system becomes more activated in the MS.
In 70 MS patients aged 55.5 ± 1.8 (mean ± SEM) years we evaluated muscle sympathetic nerve traffic (MSNA, microneurography) and venous plasma norepinephrine (NE, HPLC assay), subdividing the study population in three different subgroups according to resting clinic and 24-h HR values (< 70, 70-79 and ≥ 80 beats/min).
MS patients with clinic HR values ≥ 80 beats/min displayed MSNA and NE values significantly increased when compared to those found in MS with HR between 70 and 79 beats/min or below 70 beats/min (MSNA: 55.2 ± 0.9 vs 44.6 ± 0.6 and 39.2 ± 0.6 bursts/min, P < 0.01, NE: 403.9 ± 6.9 vs 330.1 ± 4.3 and 258.3 ± 6.8 pg/ml, respectively, P < 0.01). A similar behavior was observed for 24-h HR. In the group as a whole both MSNA and plasma NE showed highly significant direct relationships with clinic HR, the correlation being similar for MSNA and NE (r = 0.89 and r = 0.91, P < 0.01 for both) Similar significant relationships were also found between 24-h HR values and MSNA or NE.
In the MS HR values ≥ 80 beats/min are associated with an increased sympathetic activation, both when assessed by direct recording of MSNA and when evaluated as plasma NE. The sympathetic overdrive parallels for magnitude the HR elevations, this being the case for both clinic and 24-h HR.
我们研究静息心率（HR）值在多大程度上能够反映代谢综合征（MS）中不同程度的交感神经激活。我们还试图确定在何种 HR 临界值下，交感神经系统在 MS 中更为活跃。
我们评估了 70 名年龄为 55.5±1.8（均值±SEM）岁的 MS 患者的肌肉交感神经流量（MSNA，微神经记录）和静脉血浆去甲肾上腺素（NE，高效液相色谱法），根据静息临床和 24 小时 HR 值将研究人群分为三个不同亚组：<70 次/分、70-79 次/分和≥80 次/分。
静息 HR 值≥80 次/分的 MS 患者的 MSNA 和 NE 值明显高于 70-79 次/分或<70 次/分的 MS 患者（MSNA：55.2±0.9 比 44.6±0.6 和 39.2±0.6 次/分，P<0.01；NE：403.9±6.9 比 330.1±4.3 和 258.3±6.8 pg/ml，P<0.01）。24 小时 HR 也表现出类似的行为。在整个组中，MSNA 和血浆 NE 与临床 HR 呈高度显著的直接关系，MSNA 和 NE 的相关性相似（r=0.89 和 r=0.91，P<0.01）。24 小时 HR 值与 MSNA 或 NE 之间也存在显著的相关关系。
在 MS 中，静息 HR 值≥80 次/分与交感神经激活增加有关，无论是通过 MSNA 的直接记录还是通过评估血浆 NE 来评估。这种交感神经过度兴奋与 HR 升高的幅度相平行，无论是临床 HR 还是 24 小时 HR 都是如此。
