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Titolo:
Baroreflex sensitivity as a new marker for risk stratification
Autore:
La Rovere, MT;
Indirizzi:
JRCCS, Fdn S Maugeri, Div Cardiol, Ctr Med Montescano, I-27040 Montescano,Pavia, Italy JRCCS Montescano Pavia Italy I-27040 ano, I-27040 Montescano,Pavia, Italy
Titolo Testata:
ZEITSCHRIFT FUR KARDIOLOGIE
, volume: 89, anno: 2000, supplemento:, 3
pagine: 44 - 50
SICI:
0300-5860(2000)89:<44:BSAANM>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; SUDDEN CARDIAC DEATH; HEART-RATE; VENTRICULAR-FIBRILLATION; REFLEX; MORTALITY; EXERCISE; DISEASE;
Keywords:
autonomic nervous system; arterial baroreceptors; phenylephrine; sudden cardiac death; ischemic heart disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: La Rovere, MT JRCCS, Fdn S Maugeri, Div Cardiol, Ctr Med Montescano, I-27040 Montescano,Pavia, Italy JRCCS Montescano Pavia Italy I-27040 ontescano,Pavia, Italy
Citazione:
M.T. La Rovere, "Baroreflex sensitivity as a new marker for risk stratification", Z KARDIOL, 89, 2000, pp. 44-50

Abstract

As the arterial baroreflex importantly contributes to modulation of the autonomic influences on the heart and thereby arrhythmogenesis, baroreflex sensitivity has been used as a measure of the interaction between sympatheticand parasympathetic activities at the cardiac level. The most widely applied technique both in the experimental and clinical setting is the measurement of the heart rate slowing in response to a blood pressure rise induced by small intravenous boluses of phenylephrine. Baroreflex sensitivity is expressed as ms/mmHg and prevailing vagal reflexes are reflected by the wider R-R interval lengthening. The experimental evidence that the occurrence of Ventricular fibrillation was inversely related to baroreflex sensitivity, opened the way to clinical studies. The ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) trial has definitely demonstrated not only that a depressed baroreflex sensitivity (< 3 ms/mmHg) is a strong risk factor for cardiac death, but also that the information gained by the analysis of autonomic markers adds to the information obtained by better recognized measures of cardiovascular outcome such as left ventricular function and ventricular arrhythmias. The value of a depressed baroreflex sensitivity as a risk stratifier is meaningful in patients below age 65 in combination of a simultaneously depressed left ventricular ejection fraction. In these patients, the analysis of autonomic activity might be of value in the identification of patients who may need an implantable automatic defibrillator for primary prevention of sudden cardiac death.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 10:38:21