Galetta F, Puccini E, Lunardi M, Stella S M, Rossi M, Cini G, Prattichizzo F
Istituto di Clinica Medica II, Università, Pisa.
Recenti Prog Med. 1994 Dec;85(12):566-9.
Twenty patients with uncomplicated myocardial infarction randomized in two groups (group 1 and 2) of ten patients were investigated. Only group 1 trained four months according to a protocol of rehabilitation, whereas patients of group 2 followed their usual activity (control group). The autonomic cardiovascular function was estimated by Ewing's tests, that evaluate the variations of heart rate and blood pressure during deep breathing.
Our data showed an increase of parasympathetic tone in group 1 (Valsalva ratio 1.55 +/- 0.28 vs 1.36 +/- 0.28, p < 0.01; variation in heart rate during deep breathing 17.3 +/- 4.6 vs 13.3 +/- 4.2). The sympathetic activity tests showed no significant difference after training. On the other hand, group 2 showed no significant difference in sympathetic and parasympathetic activity.
In patients with uncomplicated myocardial infarction physical training increases the parasympathetic activity; as shown in the literature, such an increase can have clinical and prognostic importance, since improves cardiac performance and reduces the risk of sudden death from arrhythmic events.
选取20例无并发症的心肌梗死患者，随机分为两组（第1组和第2组），每组10例。只有第1组按照康复方案进行了4个月的训练，而第2组患者维持其日常活动（对照组）。通过尤因测试评估自主心血管功能，该测试评估深呼吸时心率和血压的变化。
我们的数据显示，第1组副交感神经张力增加（瓦尔萨尔瓦比率为1.55±0.28对1.36±0.28，p<0.01；深呼吸时心率变化为17.3±4.6对13.3±4.2）。训练后交感神经活动测试无显著差异。另一方面，第2组在交感神经和副交感神经活动方面无显著差异。
在无并发症的心肌梗死患者中，体育锻炼可增加副交感神经活动；如文献所示，这种增加具有临床和预后意义，因为它可改善心脏功能并降低心律失常事件导致猝死的风险。
