冠状动脉血管成形术引起的心率变异性变化取决于冠状动脉病变的位置。
Changes in heart rate variability caused by coronary angioplasty depend on the localisation of coronary lesions.
作者信息
Janowska-Kulińska Agnieszka, Torzyńska Katarzyna, Markiewicz-Grochowalska Agata, Sowińska Anna, Majewski Marcin, Jerzykowska Olga, Pawlak-Buś Katarzyna, Kramer Lucyna, Moczko Jerzy, Siminiak Tomasz
机构信息
Uniwersytet Medyczny w Poznaniu, Szpital Rehabilitacyjno-Kardiologiczny, ul. Sanatoryjna 34, Kowanówko, 64-600 Oborniki.
出版信息
Kardiol Pol. 2009 Feb;67(2):130-8; discussion 139.
BACKGROUND
Coronary angioplasty (PTCA) is a common treatment method in patients with coronary heart disease, but its effects on heart rate variability (HRV) have not been well established.
AIM
To verify whether the localisation of coronary lesion undergoing PTCA affects HRV parameters.
METHODS
Ninety six consecutive individuals underwent elective coronary angiography with subsequent ad hoc successful PTCA. Two five-minute ECG were recorded, one before PTCA and the second 24-hour after PTCA. The HRV indices were determined by means of classical and 'new' mathematical models.
RESULTS
The PTCA-induced changes in HRV variables depended on the localisation of dilated lesion. PTCA of the circumflex artery revealed the most significant HRV changes--a decrease in value of domain indices: Yeh DI (0.033+/-0.031 vs. 0.011+/-0.006 un/unitless, p=0.005), Yeh II (0.053+/-0.039 vs. 0.032+/-0.013 un, p=0.017), Organ BAND (9.101+/-9.245 vs. 4.62+/-2.205 bpm/beat per minute, p=0.031), Huey STV (208.821+/-262.248 vs. 76.444+/-35.281 bpm, p=0.013), Dalton MABB (15.733+/-16.575 vs. 7.57+/-4.89 ms, p=0.015), Dalton SD (48.741+/-37.468 vs. 27.759+/-10.533 ms, p=0.015), Zugaib STV (0.0129+/-0.0132 vs. 0.005+/-0.003 un, p=0.005), SDNN (27.204+/-18.592 vs. 21.329+/-32.784 ms, p=0.044), rMSSD (56.239+/-19.751 vs. 51.496+/-43.889 ms, p=0.025) and increased LF/HF (2.384+/-2.072 vs. 5.632+/-5.379 un, p=0.044). Angioplasty of the right coronary artery resulted in decreased AR TP (18.273+/-2.296 vs. 17.085+/-2.256 ms(2), p=0.017) and alteration of the sympathovagal balance of the autonomic nervous system towards predominance of sympathetic activity: AR LF (0.264+/-0.029 vs. 0.284+/-0.040 un, p=0.007), LF/HF (4.310+/-4.457 vs. 6.958+/-7.013 un, p=0.018), HF (0.199+/-0.165 vs. 0.141+/-0.157 un, p=0.031), AR HF (0.647+/-0.043 vs. 0.621+/-0.054 un, p=0.014). PTCA of the left anterior descending artery caused no change.
CONCLUSION
Changes in heart rate variability caused by coronary angioplasty depend on the localisation of coronary lesions.
背景
冠状动脉血管成形术（PTCA）是冠心病患者常用的治疗方法，但其对心率变异性（HRV）的影响尚未完全明确。
目的
验证接受PTCA治疗的冠状动脉病变部位是否会影响HRV参数。
方法
96例连续患者接受了选择性冠状动脉造影及随后成功的临时PTCA。记录两份5分钟心电图，一份在PTCA前，另一份在PTCA后24小时。HRV指标通过经典和“新”数学模型确定。
结果
PTCA引起的HRV变量变化取决于扩张病变的部位。回旋支动脉PTCA显示出最显著的HRV变化——时域指标值降低：Yeh DI（0.033±0.031对0.011±0.006单位/无量纲，p = 0.005），Yeh II（0.053±0.039对0.032±0.013单位，p = 0.017），Organ BAND（9.101±9.245对4.62±2.205次/分钟，p = 0.031），Huey STV（208.821±262.248对76.444±35.281次/分钟，p = 0.013），Dalton MABB（15.733±16.575对7.57±4.89毫秒，p = 0.015），Dalton SD（48.741±37.468对27.759±10.533毫秒，p = 0.015），Zugaib STV（0.0129±0.0132对0.005±0.003单位，p = 0.005），SDNN（27.204±18.592对21.329±32.784毫秒，p = 0.044），rMSSD（56.239±19.751对51.496±43.889毫秒，p = 0.025），且LF/HF升高（2.384±2.072对5.632±5.379单位，p = 0.044）。右冠状动脉血管成形术导致AR TP降低（18.273±2.296对17.085±2.256毫秒²，p = 0.017），自主神经系统交感迷走平衡向交感活动占优势改变：AR LF（0.264±0.029对0.284±0.040单位，p = 0.007），LF/HF（4.310±4.457对6.958±7.013单位，p = 0.018），HF（0.199±0.165对0.141±0.157单位，p = 0.031），AR HF（0.647±0.043对0.621±0.054单位，p = 0.01）。左前降支动脉PTCA未引起变化。
结论
冠状动脉血管成形术引起的心率变异性变化取决于冠状动脉病变的部位。
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