Myocardial Ischemic Changes Induced by Smorking as Monitored by Holter Electrocardiography

• Published in: Journal of the Japanese Association for Cerebro-cardiovascular Disease Control Vol. 28; no. 3; pp. 182 - 187
• Main Author: Igarashi Takeki
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for Cerebro-cardiovascular Disease Control 1994; 社団法人 日本循環器管理研究協議会
• Subjects: Ca Antagonist; Ca拮抗薬; Coronary Atherogenic Index; Silent Myocardial Ischemia; Smoking and Holter Electrocardiography; Smoking and Nitrates Effects Myocardial Scintigraphy; タバコ・ニトロール心筋シンチグラフィー; タバコ・ホルター心電図; 冠動脈硬化指数; 無症候性心筋虚血発作
• ISSN: 0914-7284
• DOI: 10.11381/jjcdp1974.28.182

In order to study effects of smoking on electrocardiographs, Holter Electrocardiographic examination concurrent with tobacco smorking were performed in 28 smokers, average age 52 years old, with no abnormal findings in usual resting ECGs.. Positive inchemic STT changes, iscluding deep T wave inversion and prominent arrhythmias were identified by the Maruquette 8200 System Analysis. These positive changes generally appeared 4-5 minutes after commencing smorking. Thirteen out of 28 (43%) of the subjects had positive findings. The positive group also had significantly elevated values for the Coronary Atherogenic Index : (TC/ HLD-C × Apo B/ Apo A-I), compared to the negative group.After premedication with Ca-antagonists, ischemic STT changes did not appear. These ischemic STT changes which did not always appear at smoking, had a tendency to show when smoking occurred during driving, in cold environment, after micturition at midnight, upon waking in the morning, probably at times of low levels of threshold. 成人喫煙常習者で安静時心電図に異状の見られない28名を対象にホルター心電図 (Marquette8200System) 検査をおこない, 喫煙時の心電図におよぼす影響を検討した。ST～Tの虚血性変化および著明な不整脈の出現した陽性群は13名, 43%にみられた。これらの変化は喫煙開始4～5分後から出現した。虚血性変化の波状的に出現するタイプと持続的にみられるタイプがあった。陽性群は陰性群に比べ冠動脈硬化指数 (TC/HLD-C×Apo B/Apo A-I) が有意に高値を示した。虚血変化陽性群にCa拮抗薬を前投与すると喫煙後のST～Tの虚血性変化は出現しなかった。また全ての喫煙時に見られるのではなく自動車運転中, 寒冷下, 夜間排尿後, 朝起床時の喫煙後など閾値の低下していると思われる際に出現した。