Abdelnabi Mahmoud, Zaki Moataz, Sadaka Mohamed, Nawar Moustafa
Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria University Alexandria, Egypt.
Cardiology Department, Faculty of Medicine, Alexandria University Alexandria, Egypt.
Am J Cardiovasc Dis. 2021 Feb 15;11(1):164-175. eCollection 2021.
To study the effects of coronary revascularization using elective percutaneous coronary intervention (PCI) on autonomic modulation assessed by heart rate variability measurement (HRV) in coronary artery disease (CAD) patients.
A single-center prospective cohort study included 100 patients were included undergoing elective PCI excluding those with contraindication to contrast or dual antiplatelet therapy, atrial fibrillation or multiple premature beats, receiving anti-arrhythmic drugs and those who underwent previous PCI or coronary artery bypass graft (CABG). Short-term measurement of time domain parameters (mean, SDNN, RMSSD) and frequency domain parameters (LF component, HF component, LF/HF ratio) of HRV was performed at the same time of the day, pre-PCI, 24 hours and 6 months post-PCI by CheckMyheart™ handheld HRV device. 5-min HRV analysis software was used to interpret the data using standard methods of HRV measurement of the Task Force of The European Society of Cardiology (ESC) and The North American Society of Pacing and Electrophysiology. SYNTAX (SX) score was calculated before PCI and residual SYNTAX (rSS) score was calculated after PCI using SYNTAX score calculator software.
The mean age of the studied population was 56.89±10.75 years with 85% males. HRV time and frequency domain parameters showed a statistically significant improvement at different time intervals (before PCI, 24 hours and 6 months after PCI) (-value <0.001). HRV time and frequency domain measures showed a statistically significant difference between time and frequency domain HRV parameters 24 hours and 6 months after PCI in patients who had complete revascularization (CR) with those who had incomplete revascularization (IR). (-value <0.001).
Autonomic modulation in CAD patients was improved by coronary revascularization using PCI assessed by serial HRV measurement. Patients with CR had better autonomic modulation than those with IR assessed by HRV 24 and 6 months after PCI.
研究采用选择性经皮冠状动脉介入治疗（PCI）进行冠状动脉血运重建对冠心病（CAD）患者自主神经调节的影响，该影响通过心率变异性测量（HRV）进行评估。
一项单中心前瞻性队列研究纳入了100例接受选择性PCI的患者，排除了那些对造影剂或双联抗血小板治疗有禁忌证、患有房颤或频发早搏、正在接受抗心律失常药物治疗以及既往接受过PCI或冠状动脉旁路移植术（CABG）的患者。使用CheckMyheart™手持式HRV设备在同一天的同一时间、PCI术前、术后24小时和术后6个月对HRV的时域参数（均值、SDNN、RMSSD）和频域参数（低频成分、高频成分、低频/高频比值）进行短期测量。使用欧洲心脏病学会（ESC）和北美心脏起搏与电生理学会特别工作组的HRV测量标准方法，通过5分钟HRV分析软件对数据进行解读。使用SYNTAX评分计算器软件在PCI术前计算SYNTAX（SX）评分，在PCI术后计算残余SYNTAX（rSS）评分。
研究人群的平均年龄为56.89±10.75岁，男性占85%。HRV时域和频域参数在不同时间间隔（PCI术前、术后24小时和术后6个月）显示出统计学上的显著改善（P值<0.001）。在接受完全血运重建（CR）的患者与接受不完全血运重建（IR）的患者中，HRV时域和频域测量结果显示，PCI术后24小时和6个月时，时域和频域HRV参数存在统计学上的显著差异（P值<0.001）。
通过连续HRV测量评估，采用PCI进行冠状动脉血运重建可改善CAD患者的自主神经调节。PCI术后24小时和6个月时，通过HRV评估，CR患者的自主神经调节优于IR患者。
