Lanza G A, Pasceri V, Colonna G, Cucinelli F, Fortini A, Lanzone A, Crea F, Maseri A
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Am J Cardiol. 1997 May 1;79(9):1174-9. doi: 10.1016/s0002-9149(97)00077-5.
An increased sensitivity to painful stimuli and an abnormal cardiac autonomic function have previously been reported in patients with angina and angiographically normal coronary arteries, a syndrome that mainly affects postmenopausal women. In this study we compared both general sensitivity to pain, by evaluating time to forearm ischemic pain (FIP) provoked by sphygmomanometer cuff inflation, and cardiac autonomic function, by measuring heart rate variability (HRV), and QT and QT(c) intervals on 24-hour Holter recordings, in 25 postmenopausal women with angina and normal coronary arteries and in 22 healthy postmenopausal women. Compared with controls, patients had a reproducible strikingly lower time to FIP (149 +/- 121 vs 295 +/- 158 seconds, p <0.001), whereas there were no differences between the 2 groups in HRV variables and mean 24-hour QT and QT(c) intervals. HRV indexes, and QT and QT(c) intervals also showed similar circadian patterns. Thus, our data show that postmenopausal women with angina and normal coronary arteries have an enhanced sensitivity to systemic painful stimuli, but no detectable impairment in cardiac autonomic function compared with a well-matched control group of postmenopausal healthy women.
先前有报道称，患有心绞痛且冠状动脉造影正常的患者对疼痛刺激的敏感性增加，且心脏自主神经功能异常，这种综合征主要影响绝经后女性。在本研究中，我们比较了25名患有心绞痛且冠状动脉正常的绝经后女性和22名健康绝经后女性对疼痛的总体敏感性（通过评估血压计袖带充气诱发的前臂缺血性疼痛（FIP）的时间）以及心脏自主神经功能（通过测量心率变异性（HRV）以及24小时动态心电图记录中的QT和QT(c)间期）。与对照组相比，患者的FIP时间显著更低且具有可重复性（149±121秒对295±158秒，p<0.001），而两组在HRV变量以及24小时平均QT和QT(c)间期方面无差异。HRV指标以及QT和QT(c)间期也显示出相似的昼夜模式。因此，我们的数据表明，患有心绞痛且冠状动脉正常的绝经后女性对全身性疼痛刺激的敏感性增强，但与匹配良好的绝经后健康女性对照组相比，心脏自主神经功能未检测到损害。
