Document Detail


The Bezold-Jarisch reflex in acute inferior myocardial infarction: clinical and sympathovagal spectral correlates.
MedLine Citation:
PMID:  12862298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The cardiodepressor Bezold-Jarisch reflex (BJR) in acute inferior myocardial infarction (AMI) is traditionally considered as an indicator of successful thrombolysis. HYPOTHESIS: The study aim was to elucidate the role of the autonomic nervous system in the pathogenesis of a BJR response in patients with AMI by tracing spectral profiles of heart rate variability (HRV). METHODS: We studied 32 patients who presented with BJR after starting intravenous thrombolysis for an inferior AMI. Spectral components of HRV were analyzed over the three specific 5-min periods preceding and following reflex activation. Clinically, the occurrence of BJR was correlated with the outcome of thrombolysis to achieve timely reperfusion and sustained coronary artery patency. RESULTS: The BJR was associated with early reperfusion in 94% of the patients, and with benign transient bradyarrhythmias and patent Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow right coronary arteries in 89% of the patients. Spectral analysis revealed a characteristic pattern of a sympathetic predominance with an impending gradual vagal withdrawal up to the onset of BJR, as reflected by progressive increases in low-frequency and reciprocal changes in high-frequency powers. CONCLUSIONS: The BJR in inferior AMI represents a reliable prognosticator of timely reperfusion and sustained coronary patency. Stimulation of vagal afferents in response to sympathetic overactivity may be the underlying pathogenetic mechanism promoting a BJR response.
Authors:
John A Chiladakis; Nikolaos Patsouras; Antonis S Manolis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  26     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-16     Completed Date:  2003-11-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  323-8     Citation Subset:  IM    
Affiliation:
Cardiology Department, Patras University Medical School, Rio, Patras, Greece.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autonomic Nervous System / physiopathology*
Blood Pressure / physiology*
Electrocardiography
Female
Heart Rate / physiology*
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology*
Myocardial Revascularization
Reflex / physiology*
Sympathetic Nervous System / physiopathology
Thrombolytic Therapy
Vagus Nerve / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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