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Titolo:
ARTERIAL BAROREFLEX IMPAIRMENT IN PATIENTS DURING ACUTE CORONARY-OCCLUSION
Autore:
AIRAKSINEN KEJ; TAHVANAINEN KUO; ECKBERG DL; NIEMELA MJ; YLITALO A; HUIKURI HV;
Indirizzi:
UNIV OULU,DEPT MED,DIV CARDIOL,CARDIOVASC LAB,KAJAANINTIE 50 FIN-90220 OULU FINLAND TAMPERE UNIV,DEPT CLIN PHYSIOL FIN-33101 TAMPERE FINLAND VIRGINIA COMMONWEALTH UNIV,MED COLL VIRGINIA RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,HUNTER HOLMES MCGUIRE DEPT VET AFFAIRS MEDCTR,DEPT MED RICHMOND VA 23298 VIRGINIA COMMONWEALTH UNIV,HUNTER HOLMES MCGUIRE DEPT VET AFFAIRS MEDCTR,DEPT PHYSIOL RICHMOND VA 23298
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 6, volume: 32, anno: 1998,
pagine: 1641 - 1647
SICI:
0735-1097(1998)32:6<1641:ABIIPD>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-ISCHEMIA; HEART-RATE-VARIABILITY; CONSCIOUS DOGS; SUDDEN-DEATH; AUTONOMIC MECHANISMS; VASCULAR-RESISTANCE; CAROTID BAROREFLEX; VAGAL-STIMULATION; INFARCTION; ANGIOPLASTY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
K.E.J. Airaksinen et al., "ARTERIAL BAROREFLEX IMPAIRMENT IN PATIENTS DURING ACUTE CORONARY-OCCLUSION", Journal of the American College of Cardiology, 32(6), 1998, pp. 1641-1647

Abstract

Objectives. We tested whether acute coronary occlusion interferes with arterial baroreceptor control of heart rate in humans. Background. Subnormal baroreflex sensitivity (BRS) is an important risk indicator for sudden death. Animal research indicates that both chronic myocardial infarction and acute coronary occlusion impair baroreflex modulationof heart rate. Methods. We measured RR interval prolongation after phenylephrine-induced systolic pressure increases before and during 2-min coronary occlusions in 47 patients (27 men) under-going clinically indicated single-vessel coronary angioplasty for stenoses in the proximal or midportion of the vessel causing >50% reduction in the arterial diameter, with normal antegrade flow (33 anterior descending, 10 circumflex, 4 right coronary artery). A control group of II patients treated for chronic total occlusion of a coronary artery was assessed to evaluate nonspecific changes in baroreflex function during a 2-min balloon inflation in the occluded artery. Results. The BRS decreased from 5.2 +/- 3.8 (mean +/- SD) to 4.1 +/- 3.5 ms mm Hg-1 (p = 0.01) during the coronary occlusion in the 28 patients with preserved arterial baroreceptor control of heart rate-that is, adequate blood pressure responses and correlation coefficients of the slopes both in baseline and during coronary occlusion. The same phenylephrine dose increased systolic pressure less during than before coronary artery occlusion (21 +/- 21 versus 36 +/- 16 mm Hg, p < 0.0001), and in 6 patients it failed to prevent systolic pressure reduction during occlusion. Correlation coefficients of the baroreflex regressions decreased from 0.81 +/- 0.27 to 0.47 +/- 0.44 (p < 0.0001) during coronary artery occlusion in the 41 patients with adequate systolic pressure rises in both phenylephrine tests, and the association between RR intervals and rising systolic pressures was lost in 13 patients during coronary occlusion. Balloon inflation in a chronic total occlusion of a coronary artery did not cause significant changes in BRS (from 5.3 +/- 4.0 to 5.2 +/- 3.7 ms mm Hg-1), correlation coefficient of the slope or phenylephrine-induced pressure rise. Conclusions. Our study shows that abrupt coronary occlusion impairs baroreflex modulation of vagal and sympathetic nervous outflow in humans. (J Am Coll Cardiol 1998;32:1641-7) (C)1998 by the American College of Cardiology.

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Documento generato il 03/12/20 alle ore 12:09:19