Skin sympathetic nerve activity and ventricular arrhythmias in acute coronary syndrome

医学 心脏病学 内科学 急性冠脉综合征 心室颤动 优势比 置信区间 早晨 室性心动过速 心源性猝死 精神压力 麻醉 心肌梗塞
作者
Tien‐Chi Huang,Shin‐Jing Lin,Chang-Jen Chen,Shih‐Jie Jhuo,Chien-Wei Chang,S. R. Lin,Nai-Yu Chi,Li‐Fang Chou,Li-Hsin Tai,Yi-Hsueh Liu,Tsung-Han Lin,Wei-Sheng Liao,Pei‐Heng Kao,Mu-Chun Cheng,Po‐Chao Hsu,Chee‐Siong Lee,Yi‐Hsiung Lin,Hsiang‐Chun Lee,Ye‐Hsu Lu,Hsueh‐Wei Yen,Tsung‐Hsien Lin,Ho‐Ming Su,Wen‐Ter Lai,Chia‐Yen Dai,Chien‐Hung Lee,Peng‐Sheng Chen,Shien‐Fong Lin,Wei‐Chung Tsai
出处
期刊:Heart Rhythm [Elsevier BV]
卷期号:19 (10): 1613-1619 被引量:5
标识
DOI:10.1016/j.hrthm.2022.04.031
摘要

Background

Acute coronary syndrome (ACS) is major cause of ventricular arrhythmias (VAs) and sudden death. neuECG is a noninvasive method to simultaneously record skin sympathetic nerve activity (SKNA) and electrocardiogram.

Objective

The purpose of this study was to test the hypotheses that (1) ACS increases average SKNA (aSKNA), (2) the magnitude of aSKNA elevation is associated with VAs during ACS, and (3) there is a gender difference in aSKNA between patients without and with ACS.

Methods

We prospectively studied 128 ACS and 165 control participants. The neuECG was recorded with electrodes at Lead I configuration at baseline, during mental math stress, and during recovery (5 minutes for each phase). All recordings were done in the morning.

Results

In the control group, women have higher aSKNA than do men at baseline (0.82 ± 0.25 μV vs 0.73 ± 0.20 μV; P = .009) but not during mental stress (1.21 ± 0.36 μV vs 1.16 ± 0.36 μV; P = .394), suggesting women had lower sympathetic reserve. In comparison, ACS is associated with equally elevated aSKNA in women vs men at baseline (1.14 ± 0.33 μV vs 1.04 ± 0.35 μV; P = .531), during mental stress (1.46 ± 0.32 μV vs 1.33 ± 0.37 μV; P = .113), and during recovery (1.30 ± 0.33 μV vs 1.11 ± 0.30 μV; P = .075). After adjusting for age and gender, the adjusted odds ratio for VAs including ventricular tachycardia and ventricular fibrillation is 1.23 (95% confidence interval 1.05–1.44) for each 0.1 μV aSKNA elevation. aSKNA is positively correlated with plasma norepinephrine level.

Conclusion

ACS is associated with elevated aSKNA, and the magnitude of aSKNA elevation is associated with the occurrence of VAs. Women have higher aSKNA and lower SKNA reserve than do men among controls but not among patients with ACS.
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