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Role of sinus node artery disease in sick sinus syndrome in inferior wall acute myocardial infarction

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      Abstract

      This study was undertaken to evaluate a possible role of sinus node (SN) artery disease in the pathogenesis of sick sinus syndrome (SSS) in patients with an inferior wall acute myocardial infarction (AMI). Coronary angiography and electrophysiologic studies of the SN, both in the basal state and after pharmacologic autonomic blockade, were performed in 23 study patients (mean age 60 years) with SSS and a previous inferior wall AMII and in another 23 control patients (mean age 57 years) with normal sinus rate and a previous inferior AMI. Stenosis of the SN artery (or that proximal to its origin) >50% was present in 13 study patients (56%) and in 8 control patients (34%) (p <0.05). In the study group, the intrinsic heart rate was abnormal in 5 of the 6 patients (83%) with severe SN artery stenosis (≥75% narrowing), in 3 of the 7 (43%) with moderate stenosis (50 to 75% narrowing) and in 3 of the 10 (30%) with insignificant stenosis (<50% narrowing). In the study group, the correlation between the SN measures (heart rate, corrected SN recovery time and sinoatrial conduction time) and the severity of SN artery stenosis was good after autonomic blockade (r between 0.59 and 0.64) and poor in the basal state. These data provide evidence for a role of SN artery disease in the pathogenesis of SSS in patients with an inferior wall AMI.
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      References

        • Parameswaran R.
        • Ohe T.
        • Goldberg H.
        Sinus node dysfunction in acute myocardial infarction.
        Br Heart J. 1976; 38: 93-96
        • Hatle T.
        • Bathen J.
        • Rokseth R.
        Sinoatrial disease in acute myocardial infarction. Long-term prognosis.
        Br Heart J. 1976; 38: 410-414
        • James T.N.
        Anatomy of the human sinus node.
        Anat Rec. 1961; 141: 109-139
        • Alboni P.
        • Malacarne C.
        • Pedroni P.
        • Masoni A.
        • Narula O.S.
        Electrophysiology of normal sinus node with and without autonomic blockade.
        Circulation. 1982; 65: 1236-1242
        • Narula O.S.
        • Samet P.
        • Javier R.P.
        Significance of the sinus node recovery time.
        Circulation. 1972; 45: 140-158
        • Narula O.S.
        • Shantha N.
        • Vasquez M.
        • Towne W.D.
        • Linhart J.W.
        A new method for measurement of sinoatrial conduction time.
        Circulation. 1978; 58: 706-714
        • Jose A.D.
        • Collison D.
        The normal range and determinants of the intrinsic heart rate in man.
        Cardiouasc Res. 1970; 4: 160-167
        • Evans R.
        • Shaw D.B.
        Pathological studies in sinoatrial disorder (sick sinus syndrome).
        Br Heart J. 1977; 39: 778-786
        • Thery C.
        • Gosselin B.
        • Lekieffre J.
        • Warembourg H.
        Pathology of sinoatrial node. Correlation with electrocardiographic finding in 111 patients.
        Am Heart J. 1977; 93: 735-740
        • Shaw D.B.
        • Linker N.J.
        • Heaver P.A.
        • Evans R.
        Chronic sinoatrial disorder (sick sinus syndrome): a possible result of cardiac ischaemia.
        Br Heart J. 1987; 58: 598-607
        • Engel T.R.
        • Meister S.G.
        • Feitosa G.S.
        • Fischer H.A.
        • Frankl W.S.
        Appraisal of sinus node artery disease.
        Circulation. 1975; 52: 286-291
        • Jordan J.
        • Yamagughi I.
        • Mandel W.J.
        Characteristics of sinoatrial conduction in patients with coronary artery disease.
        Circulation. 1976; 55: 569-574
        • Botti G.
        • Visioli O.
        • Uleri G.
        • Contorni L.
        Effetti immediati della legatura della “arteria del nodo del seno” su la funzione ritmica sinusale nel cane.
        Rass Fisiol Cl Ten. 1957; 29: 149-178
        • James T.N.
        • Hershey Jr, E.P.
        Experimental studies on the pathogenesis of atrial arrhythmias in myocardial infarction.
        Am Heart J. 1962; 63: 196-211
        • Billette J.
        • Elharrar V.
        • Porlier G.
        • Madeau R.A.
        Sinus slowing produced by experimental ischemia of the sinus node in dogs.
        Am J Cardiol. 1973; 31: 331-335