Lombardi F, Sandrone G, Pernpruner S, Sala R, Garimoldi M, Cerutti S, Baselli G, Pagani M, Malliani A
Instituto Richerche Cardiovascolari, Ospedale L. Sacco, Università Milano, Italy.
Am J Cardiol. 1987 Dec 1;60(16):1239-45. doi: 10.1016/0002-9149(87)90601-1.
By analysis of spectral components of heart rate variability, sympathovagal interaction was assessed in patients after acute myocardial infarction (AMI). At 2 weeks after AMI (n = 70), the low-frequency component was significantly greater (69 +/- 2 vs 53 +/- 3 normalized units [NU], p less than 0.05) and the high-frequency component was significantly smaller (17 +/- 1 vs 35 +/- 3 NU) than in 26 age-matched control subjects. This difference was likely to reflect an alteration of sympathovagal regulatory outflows with a predominance of sympathetic activity. At 6 (n = 33) and 12 (n = 29) months after AMI, a progressive decrease in the low- (62 +/- 2 and 54 +/- 3 NU) and an increase in the high-frequency (23 +/- 2 and 30 +/- 2 NU) spectral components was observed, which suggested a normalization of sympathovagal interaction. An increase in sympathetic efferent activity induced by tilt did not further modify the low-frequency spectral component (78 +/- 3 vs 74 +/- 3 NU) in a subgroup of 24 patients at 2 weeks after AMI. Instead, 1 year after AMI, this maneuver was accompanied by an increase in the low-frequency component (77 +/- 3 vs 53 +/- 3 NU, p less than 0.05) of a magnitude similar to the one observed in control subjects (78 +/- 3 vs 53 +/- 3 NU). These data indicate that the sympathetic predominance that is detectable 2 weeks after AMI is followed by recovery of vagal tone and a normalization of sympathovagal interaction, not only during resting conditions, but also in response to a sympathetic stimulus.
通过分析心率变异性的频谱成分，对急性心肌梗死（AMI）患者的交感神经 - 迷走神经相互作用进行了评估。在AMI后2周（n = 70），与26名年龄匹配的对照受试者相比，低频成分显著增加（69±2对53±3标准化单位[NU]，p<0.05），高频成分显著减少（17±1对35±3 NU）。这种差异可能反映了以交感神经活动占主导的交感 - 迷走神经调节输出的改变。在AMI后6个月（n = 33）和12个月（n = 29），观察到低频（62±2和54±3 NU）逐渐降低，高频（23±2和30±2 NU）频谱成分增加，这表明交感 - 迷走神经相互作用恢复正常。在AMI后2周的24名患者亚组中，倾斜诱导的交感神经传出活动增加并未进一步改变低频频谱成分（78±3对74±3 NU）。相反，在AMI后1年，这种操作伴随着低频成分增加（77±3对53±3 NU，p<0.05），增加幅度与在对照受试者中观察到的相似（78±3对53±3 NU）。这些数据表明，AMI后2周可检测到的交感神经优势之后，迷走神经张力恢复，交感 - 迷走神经相互作用正常化，不仅在静息状态下如此，而且在对交感神经刺激的反应中也是如此。
