Hikita H, Takase B, Satomura K, Kurita A, Nakamura H
First Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Scand Cardiovasc J. 1998;32(3):157-62. doi: 10.1080/14017439850140120.
The purpose of the study was to examine the differences between first and second myocardial infarctions with respect to improvement in measures of heart rate variability (HRV). The study population comprised 48 non-diabetic patients with acute myocardial infarction (AMI), and with angiographically documented coronary artery occlusion and successful reperfusion. The subjects were grouped as 35 cases with a first AMI attack and 13 with their second AMI. Two weeks after the onset of infarction, indices of HRV were higher in first infarction cases than in second infarction cases. In the latter, there were no significant increases in HRV indices from day of onset to 2 weeks later, nor were there any significant changes in left ventricular ejection fraction (LVEF) from onset to 3 weeks later. All patients studied had a patent infarct-related artery 3 weeks later. We found sustained low values of HRV after a second AMI. Different risk stratification may be needed between uncomplicated first AMI and second AMI cases.
本研究的目的是探讨首次心肌梗死与第二次心肌梗死在心率变异性（HRV）测量指标改善方面的差异。研究人群包括48例非糖尿病急性心肌梗死（AMI）患者，这些患者经血管造影证实存在冠状动脉闭塞且再灌注成功。受试者被分为35例首次发生AMI的患者和13例第二次发生AMI的患者。梗死发作两周后，首次梗死病例的HRV指标高于第二次梗死病例。在第二次梗死病例中，从发病当天到2周后HRV指标没有显著增加，从发病到3周后左心室射血分数（LVEF）也没有显著变化。所有研究患者在3周后梗死相关动脉均通畅。我们发现第二次AMI后HRV持续处于低值。单纯的首次AMI病例和第二次AMI病例可能需要不同的风险分层。
