Feng Jun, Wang Ailing, Gao Chao, Zhang Jing, Chen Zhengfei, Hou Linlin, Luo Chunmiao, Jiang Yongjing, Pan Jianyuan
Department of Cardiology, the Affiliated Hefei Hospital of Anhui Medical University (The 2nd People's Hospital of Hefei); Hefei Anhui Province-China.
Anatol J Cardiol. 2015 Jun;15(6):496-501. doi: 10.5152/akd.2014.5642. Epub 2014 Jul 17.
Dysfunction of cardiac autonomic nerve system is considered as one of risk factors for coronary atherosclerotic heart disease. Heart rate variability (HRV) has been used to study the correlation between damage of coronary artery and dysfunction of autonomic nervous system. We hypothesize the correlation between damage of coronary artery and dysfunction of autonomic nervous system by HRV among subjects with stable angina.
A 236 subjects who diagnosed as stable angina pectoris by elective coronary angiography, were divided into two groups by Gensini score system (GS):GS≤32 (GS1) and GS2>32 (GS2). Subgroups were divided based on location of stenosis lesions and the number of coronary artery disease. 86 subjects suspicious with stable angina pectoris with normal coronary angiography were selected as the control group. All subjects were received 24-hour ambulatory electrocardiogram and the result of time-domain HRV was analyzed (SDNN, SDANN, SDNNind, RMSSD, PNN50).
Compared with control group, SDNN, SDNNind and RMSSD lower in GS1, and SDNN, SDANN, SDNNind, RMSSD, PNN50 lower in GS2; ccompared with GS1, SDNN was lower in GS2. Compared with control group, SDNN in one-vessel, SDNN, SDANN in two-vessel diseased and in three-vessel diseased were lower, and compared with two-vessel diseased, SDNN, SDANN lower in three-vessel diseased. Compared with right-coronary artery diseased, SDNN and SDANN in left-coronary artery diseased group were lower, while compared with lesions in left circumflex, SDNN in lesions in left anterior descending artery lower.
HRV may be play a crucial role in estimating the correlation between damage of coronary artery and dysfunction of autonomic nerve system.
心脏自主神经系统功能障碍被认为是冠状动脉粥样硬化性心脏病的危险因素之一。心率变异性(HRV)已被用于研究冠状动脉损伤与自主神经系统功能障碍之间的相关性。我们推测在稳定型心绞痛患者中,通过HRV可反映冠状动脉损伤与自主神经系统功能障碍之间的相关性。
选取236例经选择性冠状动脉造影诊断为稳定型心绞痛的患者,根据Gensini评分系统(GS)分为两组:GS≤32(GS1)组和GS>32(GS2)组。再根据狭窄病变部位及冠状动脉病变支数进行亚组划分。选取86例冠状动脉造影正常但疑似稳定型心绞痛的患者作为对照组。所有受试者均接受24小时动态心电图检查,并分析时域HRV结果(SDNN、SDANN、SDNNind、RMSSD、PNN50)。
与对照组相比,GS1组的SDNN、SDNNind和RMSSD降低,GS2组的SDNN、SDANN、SDNNind、RMSSD、PNN50降低;与GS1组相比,GS2组的SDNN降低。与对照组相比,单支血管病变组的SDNN降低,双支血管病变组和三支血管病变组的SDNN、SDANN降低,与双支血管病变组相比,三支血管病变组的SDNN、SDANN降低。与右冠状动脉病变组相比,左冠状动脉病变组的SDNN和SDANN降低,而与左旋支病变相比,左前降支病变的SDNN降低。
HRV可能在评估冠状动脉损伤与自主神经系统功能障碍之间的相关性中起关键作用。