The time course of haemodynamic, autonomic and skeletal muscle metabolic abnormalities following first extensive myocardial infarction in man.

摘要: We investigated the time course of genesis skeletal muscle dysfunction and sympatho-vagal imbalance after myocardial infarction. studied 22 normal controls, patients with >6 months stable chronic heart failure 10 a first massive infarction at 1-3 weeks (the "early" period), 6-8 ("mid") 6-9 ("late") following their infarct. Four developed overt failure. Forearm metabolism was using (31)P magnetic resonance spectroscopy (MRS). Sympatho-vagal balance assessed by rate variability radiolabelled norepinephrine kinetics. Increased spillover (0.55+/-0.02 v 0.27+/-0.04 mg/min/m(2); P<0.01) decreased were confined to those post-myocardial who subsequently Resting cardiac output in all patients, although response supine bicycle exercise "mid" study point less group (9+/-1 41+/-8 %; P<0.005). In MRS studies, there no detectable differences between did or not develop The initial ATP turnover, calculated from initial-exercise changes pH phosphocreatine (PCr), increased established failure, but numerically similar increase reached statistical significance only early (19+/-3 11+/-1 mM/min; apparent maximum oxidative synthesis, post-exercise PCr recovery kinetics, lower than control late groups 34+/-5 55+/-4 P<0.03 38+/-3 P<0.003, respectively). Skeletal autonomic function become abnormal an extensive While abnormalities are relatively slow unrelated degree excessive neurohormonal activation impaired seem stage characterize