Mironova Tatyana, Mironov Vladimir, Antufiev Vladimir, Safronova Eleonora, Mironov Michael, Davydova Evgenia
Chelyabinsk State Medical Academy, Chelyabinsk 454091, Russia.
Recent Pat Cardiovasc Drug Discov. 2009 Jan;4(1):45-54. doi: 10.2174/157489009787259982.
The purpose of this study was to present results of special examination and prospective observation of patients with coronary artery disease (CAD) and angina pectoris (AP) in practical cardiology. Except standard cardiological methods, we used high-resolution rhythmocardiography and apparatus-program complex for registration and analysis of the heart rate variability. There was an evaluation of the autonomic and humoral-metabolic regulative influences on pacemaker activity of the heart sinus node in 273 patients selected by criteria of including-excluding patients with CAD and AP. It was determined by high-resolution HRV-analysis that ischemic heart disease is accompanied by the sinus node autonomic and humoral disregulation. Angina pectoris was correlated to HRV-stabilization on the rhythmocardiogram during ischemic episodes. Duration and frequency of these HRV-stabilization episodes permit to describe different peculiarities of the angina pectoris in every case, to predict the complication, for example, acute coronary syndrome, to define risk of lethal outcome, to study autonomic efficacy of the same drug (nitroglycerin). Prospective observations of patients with CAD permitted to create ischemic cascade in HRV-symptoms. The following conclusion can be made. High-resolution HRV analysis is an informative and perspective method in the diagnosis and management of CAD and AP. Recent patents have also disclosed methods and apparatus to reduce heart rate variability and assessment of cardiovascular risks.
本研究的目的是展示在实际心脏病学中对冠心病(CAD)和心绞痛(AP)患者进行专项检查和前瞻性观察的结果。除了标准的心脏病学方法外,我们还使用了高分辨率心节律描记术以及用于记录和分析心率变异性的仪器程序组合。对273例根据CAD和AP患者纳入 - 排除标准选取的患者,评估了自主神经和体液 - 代谢调节对心脏窦房结起搏活动的影响。通过高分辨率心率变异性分析确定,缺血性心脏病伴有窦房结自主神经和体液调节紊乱。心绞痛与缺血发作期间心节律描记图上的心率变异性稳定相关。这些心率变异性稳定发作的持续时间和频率有助于描述每种情况下心绞痛的不同特点,预测并发症,例如急性冠状动脉综合征,确定致命结局的风险,研究同一药物(硝酸甘油)的自主神经效应。对CAD患者的前瞻性观察有助于建立心率变异性症状中的缺血级联反应。可以得出以下结论。高分辨率心率变异性分析是诊断和管理CAD和AP的一种信息丰富且有前景的方法。近期的专利还公开了降低心率变异性和评估心血管风险的方法及装置。