The efficacy of pharmacological β-blockade in decreasing cardiac death in patients after myocardial infarction suggests the existence of sympathetic overactivity and indicates the importance of assessing its magnitude. The paper by Graham and co-workers in this issue of Clinical Science has attempted to address this issue by measuring muscle sympathetic nerve activity (MSNA) in various groups of patients and control subjects. It was found that, after myocardial infarction, there was sympathetic overactivity, which was more marked and more long-lasting than after unstable angina, whereas, in the presence of simple coronary artery disease, sympathetic activity did not differ from that in control subjects. Clear signs of sympathetic overactivity lasting for months after an acute myocardial infarction have already been reported using quite different methodology, i.e. spectral analysis of heart period and systolic arterial pressure variability. The soundest hypothesis to explain such a sympathetic overactivity appears to be based on the well-demonstrated finding that the ischaemic heart is a powerful site of origin of both excitatory and/or inhibitory reflexes, which may be of paramount clinical importance.
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June 01 2004
Sympathetic overactivity in ischaemic heart disease
Alberto MALLIANI;
1Dipartimento di Scienze Cliniche “Luigi Sacco”, Università degli Studi di Milano, Via GB Grassi, 74-20157 Milano, Italy
Correspondence: Professor Alberto Malliani (e-mail [email protected]).
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Nicola MONTANO
Nicola MONTANO
1Dipartimento di Scienze Cliniche “Luigi Sacco”, Università degli Studi di Milano, Via GB Grassi, 74-20157 Milano, Italy
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Publisher: Portland Press Ltd
Received:
March 05 2004
Accepted:
March 18 2004
Accepted Manuscript online:
March 18 2004
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2004 The Biochemical Society
2004
Clin Sci (Lond) (2004) 106 (6): 567–568.
Article history
Received:
March 05 2004
Accepted:
March 18 2004
Accepted Manuscript online:
March 18 2004
Citation
Alberto MALLIANI, Nicola MONTANO; Sympathetic overactivity in ischaemic heart disease. Clin Sci (Lond) 1 June 2004; 106 (6): 567–568. doi: https://doi.org/10.1042/CS20040068
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