Elhakeem Ramaze Farouke, Lutfi Mohamed Faisal, Ali Ahmed Babiker Mohamed, Sukkar Mohamed Yusif
College of Medicine, Qassim University, KSA.
Nile College of Medicine, Khartoum, Sudan.
J Clin Transl Res. 2020 Aug 12;6(2):66-70.
Presence of typical chest pain and normal coronary angiography suggests the possibility of microvascular ischemia of the myocardium as well as other non-cardiac causes that are also likely to decrease heart rate variability (HRV). This raises a question of whether poor HRV can predict abnormal elective coronary angiography (ECA).
The aim of this study was to compare HRV in patients with typical chest pain when they are classified according to ECA outcomes.
The study enrolled 150 patients planned for ECA in the cardiac center of AlShaab Teaching Hospital, Khartoum, Sudan, due to typical chest pain. Following assessment of medical history and clinical examination, the Bluetooth electrocardiography (ECG) transmitter and receiver were used for ECG recording and evaluation of time and frequency domains HRV. ECA confirmed the diagnosis of coronary artery disease (CAD) in 108 patients, who were considered as the test group. The other 42 subjects were considered as a control group after the exclusion of CAD.
The Mean±SD of Ln(pNN10), Ln(pNN20), LnLF, and LnHF was significantly higher in subjects with normal angiography compared with CAD patients. However, these statistically significant differences disappeared when the comparison was adjusted for age, gender, BMI, and HR of the studied groups.
HRV is comparable in patients with typical chest pain regardless of ECA outcomes.
The HRV differences between patients with normal and abnormal ECA are likely to be biased by CAD risk factors such as old age, male gender, and tachycardia that are known to disturb HRV. The possibility of microvascular ischemia in patients with normal ECA may have attenuated HRV in this group and make it comparable to those suffering from macrovascular ischemia due to CAD.
典型胸痛且冠状动脉造影正常提示存在心肌微血管缺血的可能性以及其他也可能降低心率变异性（HRV）的非心脏原因。这就引出了一个问题，即HRV降低是否能预测选择性冠状动脉造影（ECA）异常。
本研究的目的是比较因典型胸痛而根据ECA结果分类的患者的HRV。
本研究纳入了苏丹喀土穆AlShaab教学医院心脏中心计划进行ECA的150例因典型胸痛的患者。在评估病史和临床检查后，使用蓝牙心电图（ECG）发射器和接收器进行ECG记录以及时域和频域HRV评估。ECA确诊108例冠状动脉疾病（CAD）患者，这些患者被视为试验组。排除CAD后，其他42名受试者被视为对照组。
与CAD患者相比，血管造影正常的受试者中Ln(pNN10)、Ln(pNN20)、LnLF和LnHF的均值±标准差显著更高。然而，当对研究组的年龄、性别、BMI和心率进行校正后，这些统计学上的显著差异消失了。
无论ECA结果如何，典型胸痛患者的HRV是可比的。
正常和异常ECA患者之间的HRV差异可能受到CAD危险因素（如已知会干扰HRV的老年、男性性别和心动过速）的影响。正常ECA患者中微血管缺血的可能性可能削弱了该组的HRV，使其与因CAD导致大血管缺血的患者相当。
