在没有并发症的急性心肌梗塞后,交感神经过活性的时间过程
Lee N Graham1, Paul A Smith, John B Stoker
1Department of Cardiology, St James's University Hospital, Leeds, UK. lee@graham93.fsnet.co.uk
Circulation
|August 15, 2002
概括
在没有并发症的急性心肌梗塞 (AMI) 后,交感神经活动至少在六个月内保持升高. 这种持续的交感性过度活动可能会导致心脏病发作后的长期心血管风险.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统研究 自主神经系统研究
- 心肌梗塞研究研究
背景情况:
- 关于急性心肌梗塞 (AMI) 后同情神经系统活动的数据有限.
- 增加的同情力驱动与AMI相关的发病率和死亡率有关.
- 观察到血类甲醇胺的暂时升高,但较长期的自主变化不太了解.
研究的目的:
- 为了量化经过不复杂的AMI后,向外围的中心交感输出.
- 为了研究 AMI 后随着时间的推移对同情活动的时间进展.
- 为了比较AMI患者的同情活动与对照组.
主要方法:
- 在13名AMI患者中测量了肌肉交感神经活动 (MSNA) 和单单元MSNA (s-MSNA).
- 在AMI后2-4天进行测量,并在3个月和6个月后再次进行测量.
- 对照组包括健康受试者,冠状动脉疾病患者和非AMI住院患者.
主要成果:
- 与所有对照组相比,AMI患者的MSNA和s-MSNA在所有时间点都升高.
- 在AMI后3个月,交感活动保持不变.
- 在AMI后6个月观察到MSNA和s-MSNA的显著下降,但水平仍然高于对照组.
- 交感性过度活动与左心室喷射率相反相关.
结论:
- 在无并发性AMI后,会出现长期的同情性过度活动状态.
- 这种持续的多动性被认为有助于延迟心血管疾病和死亡率.
- 过度活跃可能是来自心脏受体的反射受损的结果.
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