Dorado M, González-Hermosillo J A, García Arenal F, Colín L, Kershenovich S, Romero L, Iturralde P
Departamento de Electrocardiografía y Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, México, DF.
Rev Esp Cardiol. 1993 Feb;46(2):71-83.
The use of the heart rate variability for the study of the Autonomic nervous system has been well established. We analyzed late potentials and heart rate variability in 29 control patients and in 102 consecutive patients with a first myocardial infarction. The data obtained were analyzed with both, the medical treatment (thrombolysis and beta-blockers) and the patency of the infarct related vessel. Patients with an infarct had diminished vagal tone as compared with the control group. Those patients with occluded related arteries showed higher incidence of late potentials; interestingly patients with late potentials also had diminished vagal tone. Without looking at the patency of the infarct related artery, thrombolitic and betablocker therapy did not have any effect on vagal tone. All the variables were correlated with the patency of the infarct related artery. Those patients with patent arteries had a preservation of the vagal tone; this was independent of the treatment received and the presence of late potentials. We concluded that the patency of the infarct related artery determines the absence of late potentials and preservation of the vagal tone. This might be one of the mechanisms of how thrombolitic therapy decreases the incidence of cardiac death.
心率变异性用于自主神经系统研究已得到充分确立。我们分析了29例对照患者和102例连续的首次心肌梗死患者的晚电位和心率变异性。所获得的数据针对药物治疗（溶栓和β受体阻滞剂）以及梗死相关血管的通畅情况进行了分析。与对照组相比，梗死患者的迷走神经张力降低。那些梗死相关动脉闭塞的患者晚电位发生率更高；有趣的是，有晚电位的患者迷走神经张力也降低。不考虑梗死相关动脉的通畅情况，溶栓和β受体阻滞剂治疗对迷走神经张力没有任何影响。所有变量均与梗死相关动脉的通畅情况相关。那些动脉通畅的患者迷走神经张力得以保留；这与所接受的治疗以及晚电位的存在无关。我们得出结论，梗死相关动脉的通畅情况决定了晚电位的不存在以及迷走神经张力的保留。这可能是溶栓治疗降低心源性死亡发生率的机制之一。
