择期经皮冠状动脉介入治疗后心率变异性参数的变化

Changes in Heart Rate Variability Parameters after Elective Percutaneous Coronary Intervention.

作者信息

Abrootan Saeed, Yazdankhah Saeed, Payami Babak, Alasti Mohammad

机构信息

Department of Cardiology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Department of Cardiology, Bahman General Hospital, Tehran, Iran.

出版信息

J Tehran Heart Cent. 2015 Apr 3;10(2):80-4.

PMID:26110006

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4477091/

Abstract

BACKGROUND

Patients with chronic stable angina often have a state of sympathetic hyperactivity. It is considered associated with myocardial ischemia and disappears after ischemia elimination. The aim of this study was to investigate the changes in heart rate variability parameters, a noninvasive technique for the evaluation of the autonomic nervous system activity, after successful revascularization in these patients to evaluate this theory.

METHODS

The patients were enrolled among those who underwent successful percutaneous coronary intervention. Short-term heart rate variability analyses of all the patients were obtained, and time-domain indices (standard deviation of normal-to-normal intervals [SDNN], standard deviation of differences of successive R-R intervals [SDSD], root-mean square differences of successive R-R intervals [rMSSD], percentage of R-R intervals differing > 10 ms from the preceding one [PNN10], percentage of R-R intervals differing > 20 ms from the preceding one [PNN20], percentage of R-R intervals differing > 30 ms from the preceding one [PNN30], percentage of R-R intervals differing > 40 ms from the preceding one [PNN40], percentage of R-R intervals differing > 50 ms from the preceding one [PNN50], percentage of R-R intervals differing > 60 ms from the preceding one [PNN60], and percentage of R-R intervals differing > 70 ms from the preceding one [PNN70]) were analyzed. All the measurements were made before and after percutaneous coronary intervention.

RESULTS

This study included 64 patients, comprising 27 men and 37 women at a mean age of 56.8 ± 9.1 years. There was a significant difference only between pre- and post-revascularization SDNN (27.5 ± 19.72 vs. 41 ± 41.4; p value = 0.013). The other parameters showed no significant differences after successful coronary intervention. Conclusion : Our data indicate that the increase in SDNN in patients with stable angina pectoris undergoing percutaneous coronary intervention seems to be prominent.

摘要

背景

慢性稳定型心绞痛患者常处于交感神经过度活跃状态。这被认为与心肌缺血有关，且在缺血消除后消失。本研究的目的是调查这些患者成功血运重建后心率变异性参数（一种评估自主神经系统活动的非侵入性技术）的变化，以评估这一理论。

方法

研究对象为成功接受经皮冠状动脉介入治疗的患者。对所有患者进行短期心率变异性分析，并分析时域指标（正常到正常间期的标准差[SDNN]、连续R-R间期差值的标准差[SDSD]、连续R-R间期的均方根差值[rMSSD]、与前一个R-R间期相差>10 ms的R-R间期百分比[PNN10]、与前一个R-R间期相差>20 ms的R-R间期百分比[PNN20]、与前一个R-R间期相差>30 ms的R-R间期百分比[PNN30]、与前一个R-R间期相差>40 ms的R-R间期百分比[PNN40]、与前一个R-R间期相差>50 ms的R-R间期百分比[PNN50]、与前一个R-R间期相差>60 ms的R-R间期百分比[PNN60]以及与前一个R-R间期相差>70 ms的R-R间期百分比[PNN70]）。所有测量均在经皮冠状动脉介入治疗前后进行。

结果

本研究纳入64例患者，其中男性27例，女性37例，平均年龄56.8±9.1岁。仅血运重建前后的SDNN存在显著差异（27.5±19.72对41±41.4；p值=0.013）。成功进行冠状动脉介入治疗后，其他参数无显著差异。结论：我们的数据表明，接受经皮冠状动脉介入治疗的稳定型心绞痛患者的SDNN升高似乎较为显著。