The autonomic disturbance accompanying myocardial infarction
To evalauate the alteration of sympatho-vagal balance after myocardial infarction we compared the spectral components of heart variability of 70 patients at 2 weeks, 6 and 12 months after myocardial infarction with 26 age matched control subjects. Spectral analysis of heart rate variability was characterized in control subjects by two major components at low (LF, ∼0.10 Hz) and high (HF, ∼0.25 Hz) frequency. According to several clinical and experimental observations they can be considered appropriate indices of, respectively sympathetic and vagal neural activities directed to the heart and their ratio an indirect measure of sympatho-vagal balance. In patients at 2 weeks after myocardial infarction there was a significant increase in LF (69±2 versus 53±3 nu) and LF/HF ratio (8±1.1 versus 2±0.3) as well as a diminished HF (17±1 versus 35±3 nu) thus indicating an increased sympathetic and a reduced parasympathetic tone. At 6 and 12 months after myocardial infarction we observed a progressive reduction of LF and LF/HF ratio as well as an increase in HF which suggested a normalization of sympatho-vagal interaction.
KeywordsMyocardial Infarction Heart Rate Variability Acute Myocardial Infarction Parasympathetic Tone Inferior Myocardial Infarction
Unable to display preview. Download preview PDF.
- 1).Hjalmarson, Å., Herlitz, J., Holmberg, S., et al. (1983) ‘The Goteborg metoprolol trial: Effetes on mortality and morbidity in acute myocardial infarction’. Circulation, 67: 126–132Google Scholar
- 2).Furberg, CD., Hawkins, CM., Lichstein, E., the Beta-Blocker Heart Attack Trial Study Group. (1984) ‘Effect of propranolol in post infarction patients with mechanical or electrical complications’. Circulation, 69: 761–765Google Scholar
- 7).Pagani, M., Lombardi, F., Guzzetti, S., Rimoldi, O., Furlan, R., Pizzinelli, P., Sandrone, G., Malfatto, G., Dell’Orto, S., Piccaluga, E,, Turiel, M., Baselli, G., Cerutti, S., Malliani, A. (1986) ‘Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog’. Circ Res, 59: 178–193PubMedGoogle Scholar
- 9).Brovelli, M., Baselli, G., Cerutti, S., Guzzetti, S., Liberati, D., Lombardi, F., Malliani, A., Pagani, M., Pizzinelli, P. (1983) ‘Computerized analysis for an experimental validation of neurophysiological models of heart rate control’. Comps in Cardiol 205–208Google Scholar
- 12).Furlan, R., Guzzetti, S., Crivellaro, W., Dassi, S., Tinelli, M., Baselli, G., Cerutti, S., Lombardi, F., Pagani, M., Malliani, A. (1990) ‘Continuous 24H assessment of the neural regulation of systemic arterial pressure and R-R variabilities in ambulant subjects’. Circulation (in press)Google Scholar
- 13).Lombardi, F., Montano, N., Finocchiaro, ML., Gnecchi Ruscone, T., Baselli, G., Cerutti, S., Malliani, A. (1990) ‘Spectral analysis of sympathetic discharge in decerebrate cats’. J Autonom Nerv Syst, (in press)Google Scholar
- 15).Kleiger, RE., Miller, JP., Bigger, JT., Moss, AJ., and the multicenter post-infarction research group. (1987) ‘Decreased heart rate variability and its association with increased mortality after acute myocardial infarction’. Am J Cardiol 59: 256–262Google Scholar