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Cold and ischaemic heart disease
1University of Lund, Heart Clinic, University Hospital, Malmö, Sweden.
Insights
Patients experiencing sudden cardiac death after acute myocardial infarction showed a greater increase in diastolic blood pressure and heart rate during cold exposure tests. This physiological response may indicate heightened cardiovascular risk.
Area of Science:
- Cardiology
- Physiology
Background:
- Acute myocardial infarction (AMI) survivors face risks of reinfarction and death.
- Assessing cardiovascular stress responses is crucial for risk stratification.
Purpose of the Study:
- To investigate the cardiovascular response to cold pressor testing in AMI patients.
- To determine if specific physiological reactions correlate with adverse outcomes like sudden death.
Main Methods:
- 268 patients with AMI underwent a cold pressor test (hand in ice water for 10 minutes).
- Electrocardiogram (ECG), blood pressure (BP), and heart rate (HR) were monitored.
- Patients were followed for one year for reinfarction, or sudden (SD) or other (OSD) death.
Main Results:
- Patients who experienced SD showed a significantly higher rise in diastolic BP compared to those with no AMI or OSD.
- Heart rate increased more in the SD group than in the no AMI group.
- Elevated diastolic BP and HR during cold stress were associated with increased risk of sudden death.
Conclusions:
- The cold pressor test can reveal significant physiological differences in AMI patients at risk for sudden death.
- Increased diastolic blood pressure and heart rate during cold exposure may serve as indicators of heightened cardiovascular risk post-AMI.
Abstract:
As part of a comprehensive program, including an exercise test, a long-term ECG recording, a psychic stress test, and administration of nitrogylcerin, 268 patients with an acute myocardial infarction (AMT) were submitted to a cold pressor test, holding the right hand in ice water for 10 minutes. Electrocardiogram (ECG), blood pressure (BP), and heart rate (HR) were determined before and at 2 minutes intervals during cold exposure. The patients were followed for one year for re AMI, no AMI, and death, sudden (SD) or not sudden (OSD). Patients with SD showed a significantly higher rise in diastolic BP than those with no AMI (0.001 < P < 0.01) or OSD (0.01 < P < 0.05). HR increased more in SD than in no AMI patients (0.001 < P < 0.01). Different physiological and metabolic reactions to cold exposure will be discussed.