PDF(Pubmed)
Abstract：
UNASSIGNED: ST-segment depression (ST depression) on exercise electrocardiogram (ECG) and ambulatory ECG monitoring may occur without myocardial ischemia. The mechanisms of nonischemic ST depression remain poorly understood.
UNASSIGNED: The study sought to test the hypothesis that the magnitudes of skin sympathetic nerve activity (SKNA) correlate negatively with the ST-segment height (ST height) in ambulatory participants.
UNASSIGNED: We used neuECG (simultaneous recording of SKNA and ECG) to measure ambulatory ST height and average SKNA (aSKNA) in 19 healthy women, 6 women with a history of Takotsubo syndrome (TTS), and 4 women with ischemia and no obstructive coronary arteries (INOCA).
UNASSIGNED: Baseline aSKNA was similar between healthy women, women with TTS, and women with INOCA (1.098 ± 0.291 μV, 0.980 ± 0.061 μV, and 0.919 ± 0.0397 μV, respectively; P = .22). The healthy women had only asymptomatic upsloping ST depression. All participants had a significant (P < .05) negative correlation between ST height and aSKNA. Ischemic episodes (n = 15) were identified in 2 TTS and 4 INOCA participants. The ischemic ST depression was associated with increased heart rate and elevated aSKNA compared with baseline. An analysis of SKNA burst patterns at similar heart rates revealed that SKNA total burst area was significantly higher during ischemic episodes than nonischemic episodes (0.301 ± 0.380 μV·s and 0.165 ± 0.205 μV·s; P = .023) in both the TTS and INOCA participants.
UNASSIGNED: Asymptomatic ST depression in ambulatory women is associated with elevated SKNA. Heightened aSKNA is also noted during ischemic ST depression in women with TTS and INOCA. These findings suggest that ST segment depression is a physiological response to heightened sympathetic tone but may be aggravated by myocardial ischemia.
UNASSIGNED: The study sought to test the hypothesis that the magnitudes of skin sympathetic nerve activity (SKNA) correlate negatively with the ST-segment height (ST height) in ambulatory participants.
UNASSIGNED: We used neuECG (simultaneous recording of SKNA and ECG) to measure ambulatory ST height and average SKNA (aSKNA) in 19 healthy women, 6 women with a history of Takotsubo syndrome (TTS), and 4 women with ischemia and no obstructive coronary arteries (INOCA).
UNASSIGNED: Baseline aSKNA was similar between healthy women, women with TTS, and women with INOCA (1.098 ± 0.291 μV, 0.980 ± 0.061 μV, and 0.919 ± 0.0397 μV, respectively; P = .22). The healthy women had only asymptomatic upsloping ST depression. All participants had a significant (P < .05) negative correlation between ST height and aSKNA. Ischemic episodes (n = 15) were identified in 2 TTS and 4 INOCA participants. The ischemic ST depression was associated with increased heart rate and elevated aSKNA compared with baseline. An analysis of SKNA burst patterns at similar heart rates revealed that SKNA total burst area was significantly higher during ischemic episodes than nonischemic episodes (0.301 ± 0.380 μV·s and 0.165 ± 0.205 μV·s; P = .023) in both the TTS and INOCA participants.
UNASSIGNED: Asymptomatic ST depression in ambulatory women is associated with elevated SKNA. Heightened aSKNA is also noted during ischemic ST depression in women with TTS and INOCA. These findings suggest that ST segment depression is a physiological response to heightened sympathetic tone but may be aggravated by myocardial ischemia.
摘要：
■运动心电图（ECG）和动态心电图监测中的ST段压低（ST压低）可能在没有心肌缺血的情况下发生。非缺血性ST段压低的机制仍然知之甚少。
■该研究试图检验以下假设：在非卧床参与者中，皮肤交感神经活动（SKNA）的幅度与ST段高度（ST高度）呈负相关。
■我们使用neuECG（同时记录SKNA和ECG）测量了19名健康女性的动态ST高度和平均SKNA（aSKNA），6例有Takotsubo综合征（TTS）病史的女性，和4名缺血且无阻塞性冠状动脉（INOCA）的女性。
■基线aSKNA在健康女性之间相似，女性TTS，和患有INOCA的女性（1.098±0.291μV，0.980±0.061μV,和0.919±0.0397μV，分别为；P=.22）。健康女性仅有无症状的ST抑郁。所有受试者ST段高度与aSKNA呈显著负相关(P<.05)。在2名TTS和4名INOCA参与者中发现了缺血发作(n=15)。与基线相比，缺血性ST段压低与心率增加和aSKNA升高相关。对相似心率下的SKNA爆发模式的分析表明，在TTS和INOCA参与者中，缺血性发作期间的SKNA总爆发面积明显高于非缺血性发作（0.301±0.380μV·s和0.165±0.205μV·s；P=0.023）。
■非卧床女性无症状ST段抑郁与SKNA升高相关。在患有TTS和INOCA的女性中，缺血性ST抑郁期间也注意到aSKNA升高。这些发现表明，ST段压低是对交感神经张力增强的生理反应，但可能因心肌缺血而加重。
■该研究试图检验以下假设：在非卧床参与者中，皮肤交感神经活动（SKNA）的幅度与ST段高度（ST高度）呈负相关。
■我们使用neuECG（同时记录SKNA和ECG）测量了19名健康女性的动态ST高度和平均SKNA（aSKNA），6例有Takotsubo综合征（TTS）病史的女性，和4名缺血且无阻塞性冠状动脉（INOCA）的女性。
■基线aSKNA在健康女性之间相似，女性TTS，和患有INOCA的女性（1.098±0.291μV，0.980±0.061μV,和0.919±0.0397μV，分别为；P=.22）。健康女性仅有无症状的ST抑郁。所有受试者ST段高度与aSKNA呈显著负相关(P<.05)。在2名TTS和4名INOCA参与者中发现了缺血发作(n=15)。与基线相比，缺血性ST段压低与心率增加和aSKNA升高相关。对相似心率下的SKNA爆发模式的分析表明，在TTS和INOCA参与者中，缺血性发作期间的SKNA总爆发面积明显高于非缺血性发作（0.301±0.380μV·s和0.165±0.205μV·s；P=0.023）。
■非卧床女性无症状ST段抑郁与SKNA升高相关。在患有TTS和INOCA的女性中，缺血性ST抑郁期间也注意到aSKNA升高。这些发现表明，ST段压低是对交感神经张力增强的生理反应，但可能因心肌缺血而加重。
