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M. S. DETOLLENAERE, D. A. DUPREZ, M. L. DE BUYZERE, H. J. VANDEKERCKHOVE, G. G. DE BACKER, D. L. CLEMENT, Autonomic imbalance in the recovery period after myocardial infarction, European Heart Journal, Volume 14, Issue 9, September 1993, Pages 1189–1194, https://doi.org/10.1093/eurheartj/14.9.1189
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Abstract
The aim of the study was to evaluate the responses to autonomic function tests during the healing period of myocardial infarction (AMI). In 24 patients, at 2 and 6 weeks after the acute event, Valsalva manoeuvre, deep breathing at 6 breaths per min, isometric handgrip and cold pressor tests were performed. Responses of arterial blood pressure (BP) and heart rate (HR) were measured. At 2 weeks post AMI a significant decrease in parasympathetic tone was noted: HR reduction during deep breathing: 18.5±5.7 beats. min−1 for controls vs 9.7±2.6 beats. min−1 for AMI, P<0.001. Systolic BP response to handgrip and coldpressor test was only slightly (non signflcantly) increased: 30.6±12.9 mmHg (controls) vs 40.0±20.5mmHg (AMI) for the handgrip test and 13.8±8.1 mmHg vs 18.0± 10.1 mmHg respectively for the cold pressor test. At 6 weeks post AMI, the response to the deep breathing test (15.9±5.6 beats. min−1)no longer significantly differed from that in controls. In contrast, the sympathetic stressor tests showed a signficant increase in systolic BP response: 63.8±21.9mmHg, P<0.001 and 26.1±14.9 mmHg, P<0.05, respectively for the handgrip and cold pressor tests. It appeared that infarct localization had no effect on autonomic function tests.
There is evidence of autonomic imbalance both at 2 and at 6 weeks after AMI, with a rapid but transient decrease in vagal activity and enhancement of orthosympathetic nervous tone; this was markedly more pronounced at 6 weeks post AMI despite treatment with beta-blocking agents in all patients.
