选择性自主封锁对人类T波替代体的影响
Eric J Rashba1, Michael Cooklin, Karen MacMurdy
1Division of Cardiology, Department of Medicine, University of Maryland at Baltimore, 21201, USA. erashba@medicine.umaryland.edu
Circulation
|February 21, 2002
概括
交感神经系统活动显著影响高风险心脏病患者的T波替代 (TWA) 测量. 使用β-阻断剂可能会减少TWA,可能降低心脏突然死亡风险.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 自主神经系统的自主神经系统
背景情况:
- T波替代体 (TWA) 是一个关键的非侵入性标志物,用于检测心室心律失常的脆弱性.
- 冠状动脉疾病 (CAD) 患者患心律不整的风险很高.
- 在这些患者中,自主神经系统 (ANS) 在TWA中的作用尚未完全理解.
研究的目的:
- 研究自主神经系统对TWA测量的影响.
- 在高风险冠状动脉疾病患者中评估TWA.
- 为了确定是否同情或寄同情阻塞会影响TWA.
主要方法:
- 研究了60名患有左心室功能障碍和诱导性心室动脉冲动症的CAD患者.
- 在基线和交感阻塞 (埃斯莫洛尔),副交感阻塞 (氨酸) 或没有干预 (对照) 后测量TWA.
- 在TWA测量期间使用心房节奏来标准化心率.
主要成果:
- 副交感阻塞 (热素) 和控制条件没有改变TWA流行率.
- 使用埃斯莫洛尔的交感阻塞显著降低了TWA振幅 (P<0.001).
- 埃斯莫洛尔可以将阳性TWA测试减少50% (70%至35%,P<0.05).
结论:
- 自主神经系统调制,特别是同情活动,影响TWA.
- 对于患有CAD的风险分层患者来说,TWA可能是一个有用的工具.
- β抑制剂可能通过对CAD患者的TWA产生有利影响来降低突然心脏死亡风险.
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