葡萄酒增加冠状动脉疾病女性病患的心跳速率变异

By Laurie Barclay, MD

　　Feb. 16, 2005 - 根据一项发表于2月号心脏期刊的断面试验结果显示，喝葡萄酒，而不是啤酒或是烈酒，会增加女性冠状动脉疾病（CHD）病患的心跳速率变异。
　　
　　瑞典Stockholm Karolinska机构I. Janszky表示，流行病学数据显示，饮用少许酒精性饮料，特别是葡萄酒，与CHD发病率与死亡率下降有关；HRV是心跳速率波动的程度，被认为是自主神经系统活性一种可靠、非侵袭性指标；HRV的下降已经被发现可以预测健康人、以及急性冠状动脉事件后病患的CHD发病率与死亡率。
　　
　　研究人员收纳了102位急性心肌梗塞后存活住院、或是接受经皮穿璧冠状动脉成型术、冠状动脉绕道手术的病患；受试者完成一份有关饮用啤酒、葡萄酒与烈酒的问卷，并且她们接受院外的24小时的心电图（ECG）检查；ECG检查项目包括总能量、高频能量、低频能量与超低频能量。
　　
　　在多变项分析模式中，饮用葡萄酒与时间及频率区段的HRV增加正相关，而且这个关系与临床共同变相之间没有关联；举例来说，饮用葡萄酒的女性受试者，在整个纪录的所有5分钟片段之间，正常与正常间隔的标准偏差平均值为3.89，而不喝葡萄酒的女性受试者为3.59（P＝.014）；然而，啤酒与烈酒的总摄取量，及酒精总摄取量与任何HRV参数的变化之间并没有关联。
　　
　　该项试验的限制，包括采用自行报告的酒精摄取量、观察性试验设计、可能会因为多元不饱和脂肪酸或是其他变项造成残余干扰、样品数目太小，以致于无法侦测出HRV与啤酒或是烈酒摄取量、或是酒精总摄取量之间的关连、某些女性因为其疾病严重性的反应而停止饮酒、以及无法得知对男性或是重度酗酒者的影响。
　　
　　研究人员表示，喝葡萄酒，而不是烈酒或是啤酒，正面地且独立地与女性CHD患者的HRV有关；这些结果可能使我们对饮酒与CHD之间的关系更加了解。
　　
　　Ansgarius基金会、Belven基金会、Swedish心脏与肺脏基金会、公共卫生委员会与Stockholm的Expo－95郡议会、瑞典医学研究议会、与Stockholm的Vardal基金会赞助这项试验；研究人员表示，并没有任何的利益冲突。

Wine Increases Heart Rate Variability in Women With Coronary Heart Disease

By Laurie Barclay, MD


Feb. 16, 2005 — Drinking wine, but not beer or spirits, increases heart rate variability (HRV) in women with coronary heart disease (CHD), according to the results of a cross-sectional study published in the February issue of Heart.

"Compelling epidemiological evidence suggests that moderate intake of alcoholic beverages, especially wine, is associated with lower risk of [CHD] morbidity and mortality," write I. Janszky, from the Karolinska Institute in Stockholm, Sweden, and colleagues. "HRV, the amount of fluctuation of the beat to beat differences, is known to be a reliable, noninvasive marker of autonomic nervous system activity. Decrease in HRV has been found to predict CHD morbidity and mortality in apparently healthy populations and in patients after an acute coronary event."

The investigators enrolled 102 women who survived hospitalization for acute myocardial infarction or underwent a revascularization procedure, percutaneous transluminal coronary angioplasty, or coronary artery bypass grafting. These women completed a standardized questionnaire regarding self-reported consumption of beer, wine, and spirits, and they underwent ambulatory 24-hour electrocardiogram (ECG) during normal activities. ECG outcome measures included total power, high frequency power, low frequency power, and very low frequency power.

Wine consumption was positively associated with increased HRV in both time and frequency domains, and this association was independent of other clinical covariates. In the multivariate model, for example, mean of the standard deviations of all normal to normal intervals for all five-minute segments of the entire recording was 3.89 for wine drinkers and 3.59 for women who did not drink wine (P = .014). However, intake of beer or spirits and the total amount of alcohol consumed did not correlate significantly with any of the HRV parameters.

Study limitations include the use of self-reported assessment of alcohol intake, observational design, possible residual confounding by polyunsaturated fatty acids or other variables, insufficient sample size to detect an association between HRV and consumption of beer or spirits or total amount of alcohol, the possibility that some women stopped drinking in response to the severity of their illness, and inability to generalize the findings to men or to heavier alcohol consumption.

"Intake of wine, but not of spirits or beer, is positively and independently associated with HRV in women with CHD," the authors write. "These results may contribute to the understanding of the complex relation between alcohol consumption and CHD."

The Ansgarius Foundation, the Belvén Foundation, the Swedish Heart and Lung Foundation, the Public Health Committee and Expo-95 of Stockholm County Council, the Swedish Medical Research Council, and the Vardal Foundation in Stockholm supported this study. The authors report no conflicts of interest.

Heart. 2005;91:314-318

Reviewed by Gary D. Vogin, MD