Document Detail

Original articles primary coronary angioplasty and subsequent cardiovascular rehabilitation are linked to a favorable sympathovagal balance after a first anterior myocardial infarction.
MedLine Citation:
PMID:  15773269     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Modulation of the autonomic tone may contribute to the positive clinical effects of reperfusion of the ischemic zone after acute myocardial infarction (AMI). Little information exists about the effects on the sympathovagal balance of the early reopening of the vessel achieved by means of primary coronary angioplasty (PTCA). Even less is known on the autonomic effects of rehabilitation in patients undergoing PTCA. METHODS: We performed spectral analysis of the RR interval variability during 15 min of ECG in resting conditions in 51 patients (47 males, 4 females, mean age 55 +/- 6 years) 2-3 weeks after a first anterior AMI, and after 8 weeks of rehabilitation with physical training. The ratio between the low- and high-frequency (LF/HF) components of each autospectrum was used to describe the sympathovagal balance. Patients were divided into three groups: group 1 (n = 26, primary PTCA/stenting); group 2 (n = 11, recombinant tissue-type plasminogen activator); group 3 (n = 14, no reperfusion). Treatment was similar in the three groups and was maintained during the whole rehabilitation period. Results. Before rehabilitation, group 1 showed an adrenergic activation that was more blunted than that observed in groups 2 and 3. This activation was maximal in those patients with the shortest delay before the procedure. Cardiovascular rehabilitation modulated the LF/HF ratio in all groups. CONCLUSIONS: Early and effective reperfusion of the infarct-related artery is associated with a better sympathovagal tone shortly after AMI; this is followed by the known benefits of cardiovascular rehabilitation on autonomic tone.
Gabriella Malfatto; Simonetta Blengino; Luca Annoni; Giovanna Branzi; Caterina Bizzi; Mario Facchini
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Italian heart journal : official journal of the Italian Federation of Cardiology     Volume:  6     ISSN:  1129-471X     ISO Abbreviation:  Ital Heart J     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-03-18     Completed Date:  2005-06-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100909716     Medline TA:  Ital Heart J     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  21-7     Citation Subset:  IM    
Division of Cardiology, Istituto Scientifico Ospedale San Luca, Istituto Auxologico Italiano IRCCS, Milan, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Exercise Therapy
Follow-Up Studies
Heart Rate / physiology*
Heart Ventricles / innervation*,  physiopathology,  ultrasonography
Middle Aged
Myocardial Infarction / physiopathology*,  rehabilitation*,  ultrasonography
Retrospective Studies
Stroke Volume / physiology
Sympathetic Nervous System / physiopathology*
Treatment Outcome
Vagus Nerve / physiopathology*

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