Chen Yafei, Yu Yijun, Zou Wusong, Zhang Mingjing, Wang Yuting, Gu Ye
Department of Cardiology, Puai Hospital, Huazhong University of Science and Technology, Wuhan, China.
J Int Med Res. 2018 Sep;46(9):3729-3740. doi: 10.1177/0300060518778416. Epub 2018 Jun 25.
Objective Autonomic dysfunction is recognized in patients with coronary artery disease (CAD) and is related to worse cardiovascular outcome. This study aimed to evaluate cardiac autonomic nervous function by heart rate recovery (HRR) and heart rate variability (HRV), and demonstrate their relationship with the severity of coronary lesions in patients with stable CAD (SCAD). Methods Consecutive patients without CAD (controls, n = 65) and those with SCAD (n = 63) were included in this study. Patients with SCAD were further divided into single- or two-/three-vessel disease, as well as <70% or ≥70% stenosis subgroups. The association between HRR/HRV and coronary lesions was analysed. Results HRR and HRV values were significantly lower in the SCAD group compared with the control group. Multivariate logistic regression analysis showed that abnormal HRR and HRV were risk factors of SCAD. Moreover, delayed HRR was a risk factor of the severity of coronary lesions. Conclusions Our results show that autonomic function is impaired in patients with SCAD and delayed HRR is closely related to the severity of coronary lesions.
目的 冠状动脉疾病（CAD）患者存在自主神经功能障碍，且与更差的心血管结局相关。本研究旨在通过心率恢复（HRR）和心率变异性（HRV）评估心脏自主神经功能，并阐明其与稳定型CAD（SCAD）患者冠状动脉病变严重程度的关系。方法 本研究纳入了无CAD的连续患者（对照组，n = 65）和SCAD患者（n = 63）。SCAD患者进一步分为单支或双支/三支血管病变，以及狭窄<70%或≥70%亚组。分析HRR/HRV与冠状动脉病变之间的关联。结果 与对照组相比，SCAD组的HRR和HRV值显著更低。多因素逻辑回归分析显示，HRR和HRV异常是SCAD的危险因素。此外，HRR延迟是冠状动脉病变严重程度的危险因素。结论 我们的结果表明，SCAD患者的自主神经功能受损，且HRR延迟与冠状动脉病变严重程度密切相关。
