探索急性心肌梗死后睡眠模式、心脏自主神经功能与传统心血管危险因素之间的相互作用。

Exploring the Interaction Between Sleep Patterns, Cardiac Autonomic Function, and Traditional Cardiovascular Risk Factors Following Acute Myocardial Infarction.

作者信息

Hbaieb Mohamed Ali, Bosquet Laurent, Hammouda Omar, Hbaieb Raghda, Mezghani Ines, Charfeddine Salma, Abid Leila, Turki Mouna, Driss Tarak, Dugué Benoit

机构信息

Laboratory Mobilité, Vieillissement, Exercise (MOVE) (UR20296), Faculty of Sport Sciences, University of Poitiers, Poitiers, France.

Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia.

出版信息

Clin Cardiol. 2025 Jul;48(7):e70183. doi: 10.1002/clc.70183.

DOI:10.1002/clc.70183

PMID:40704501

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12287801/

Abstract

BACKGROUND

Monitoring lifestyle habits and physiological metrics are essential for improving cardiovascular outcomes and supporting recovery after acute cardiac events. Sleep is acknowledged as a core component of cardiovascular health and a predictive tool of adverse outcomes following acute myocardial infarction (AMI).

OBJECTIVE

The present study aimed to assess sleep metrics and explore the links between sleep patterns, heart rate variability (HRV) parameters, and traditional cardiovascular risk factors in patients with AMI.

METHODS

Sixty male patients with AMI (56.77 ± 8.24 years) participated in this study. Cardiac autonomic function was assessed with short-term HRV analysis during the second week post-AMI. Physical activity level was assessed using accelerometers. Sleep quality and quantity were evaluated objectively using a wrist-worn accelerometer and subjectively by the Pittsburgh Sleep Quality Index. Chronotype was evaluated with the Horne and Otsberg questionnaire.

RESULTS

Twenty post-AMI patients (33.3%) tended to experience poor sleep quality, with a sleep efficiency inferior to 85%. Thirty patients (50%) experienced short sleep duration, 16 (26.7%) had a healthy sleep duration (7-8 h), and 14 (23.3%) slept more than 8 h. Multiple regression analysis revealed that patients with healthy sleep quality and quantity exhibited higher HRV parameters, both in time and frequency domain values (p < 0.05). Low physical activity level was observed in patients with long sleep duration (p = 0.005) and evening chronotype (p = 0.022).

CONCLUSION

Patients who spent more time performing moderate to vigorous physical activity tended to exhibit good sleep health and increased parasympathetic activity which are considered cardioprotective after AMI.

TRIAL REGISTRATION

PACTR202208834230748.

摘要

背景

监测生活方式习惯和生理指标对于改善心血管疾病预后以及支持急性心脏事件后的恢复至关重要。睡眠被认为是心血管健康的核心组成部分，也是急性心肌梗死（AMI）后不良结局的预测工具。

目的

本研究旨在评估AMI患者的睡眠指标，并探讨睡眠模式、心率变异性（HRV）参数与传统心血管危险因素之间的联系。

方法

60例男性AMI患者（56.77±8.24岁）参与了本研究。在AMI后第二周，通过短期HRV分析评估心脏自主神经功能。使用加速度计评估身体活动水平。使用腕部佩戴的加速度计客观评估睡眠质量和数量，并通过匹兹堡睡眠质量指数主观评估。使用霍恩和奥茨伯格问卷评估昼夜节律类型。

结果

20例AMI后患者（33.3%）睡眠质量较差，睡眠效率低于85%。30例患者（50%）睡眠持续时间短，16例（26.7%）睡眠持续时间健康（7-8小时），14例（23.3%）睡眠超过8小时。多元回归分析显示，睡眠质量和数量健康的患者在时域和频域值方面均表现出较高的HRV参数（p<0.05）。睡眠持续时间长的患者（p=0.005）和夜间型昼夜节律患者（p=0.022）身体活动水平较低。