Pitzalis M V, Mastropasqua F, Massari F, Passantino A, Luzzi G, Ligurgo L, Colombo R, Biasco M G, Rizzon P
Institute of Cardiology, University of Bari Italy, Veruno, Italy.
Pacing Clin Electrophysiol. 1998 Jun;21(6):1230-8. doi: 10.1111/j.1540-8159.1998.tb00182.x.
Modifications in heart rate variability (HRV) parameters occur after acute myocardial infarction. The aim of this study was to evaluate the trend of HRV change during the acute phase and the first month after myocardial infarction, and establish whether they were affected by the anterior or inferior location of the infarction. The time-domain HRV measures of 59 patients with a first uncomplicated acute myocardial infarction were computed from 24-hour ECG recordings made on days 1, 2, 10, and 28 after hospital admission. At day 1, the mean RR cycle length (NN), the standard deviation of the NN intervals (SDNN), and the root mean square successive difference of NN intervals (RMSSD) were lower in the patients with anterior myocardial infarction. Although the parameters were similar in all of the patients at day 28, their behavior over time was different (P = 0.01): the SDNN in the patients with inferior myocardial infarction had decreased to the values found in anterior myocardial infarction patients by day 2 but, at day 10, both NN and SDNN tended to recover in both groups; RMSSD had diminished in both groups by day 2, but at day 10, had increased in the patients with anterior, but not in those with inferior myocardial infarction. These findings suggest that (1) in the very early phase of myocardial infarction, HRV is different in the two locations, (2) during the first hours of myocardial infarction patients with inferior location showed a greater vagal activity than patients with anterior location that became lower at day 10, and (3) the recovery of HRV is an early phenomenon in both groups, being already evident by the second week after myocardial infarction.
急性心肌梗死后心率变异性（HRV）参数会发生改变。本研究的目的是评估心肌梗死后急性期及第一个月内HRV变化的趋势，并确定其是否受梗死部位在前壁还是下壁的影响。对59例首次发生无并发症急性心肌梗死的患者，在入院后第1天、第2天、第10天和第28天进行24小时心电图记录，计算其时域HRV指标。在第1天，前壁心肌梗死患者的平均RR周期长度（NN）、NN间期标准差（SDNN）和NN间期的均方根连续差值（RMSSD）较低。虽然在第28天时所有患者的这些参数相似，但它们随时间的变化情况不同（P = 0.01）：下壁心肌梗死患者的SDNN在第2天时已降至前壁心肌梗死患者的水平，但在第10天时，两组的NN和SDNN均有恢复趋势；两组的RMSSD在第2天时均降低，但在第10天时，前壁心肌梗死患者的RMSSD升高，而下壁心肌梗死患者的RMSSD未升高。这些发现表明：（1）在心肌梗死的极早期，两个部位的HRV不同；（2）在心肌梗死的最初几个小时内，下壁心肌梗死患者的迷走神经活动比前壁心肌梗死患者更强，且在第10天时降低；（3）两组HRV的恢复都是早期现象，在心肌梗死后第二周就已明显。
