Singh Pradyumna K, Kumar Tarun, Pandit Bhagya Narayan, Tile Bhushan, Kumawat Abhishek
Cardiology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.
Cureus. 2024 Dec 15;16(12):e75756. doi: 10.7759/cureus.75756. eCollection 2024 Dec.
Background Autonomic dysfunction is associated with adverse outcomes in patients with coronary artery disease. Cardiac autonomic dysfunction parameters such as heart rate variability (HRV) and heart rate recovery (HRR) have been studied individually and have been linked to the presence or likelihood of coronary artery disease. In this study, the cardiac autonomic function was assessed in terms of HRR and HRV. In addition, the association of these parameters with the severity of coronary artery lesions was studied. Methodology A total of 100 patients aged more than 18 years who had complaints of typical angina were enrolled in this study. These patients had to undergo the treadmill test for HRR and 24-hour Holter monitoring for HRV. These patients then underwent invasive coronary angiography, and the severity of the lesions was described as single vessel or two/three (multivessel) involvement. The lesions were also grouped as lesions with <70% stenosis and ≥70% stenosis. The association between the severity of the lesions and autonomic dysfunction was studied. Results HRR and HRV values were associated with patients with more severe disease. Multivariate regression analysis showed that abnormal HRV was associated with more severe disease; however, abnormal HRR was not directly associated with lesion severity. These autonomic parameters had a negative correlation with the SYNTAX Score. Conclusions Our results showed that autonomic dysfunction was associated with more severe coronary artery disease in patients with chronic coronary syndrome. We observed a negative correlation between HRR1 and HRV with the severity of coronary artery disease. Hence, we may try to incorporate these parameters in screening patients with a low likelihood of CAD. Future studies may be planned to see any improvement in cardiac autonomic function after revascularization and its association with outcome.
背景 自主神经功能障碍与冠状动脉疾病患者的不良预后相关。心率变异性（HRV）和心率恢复（HRR）等心脏自主神经功能障碍参数已被单独研究，并与冠状动脉疾病的存在或可能性相关联。在本研究中，根据HRR和HRV评估心脏自主神经功能。此外，还研究了这些参数与冠状动脉病变严重程度的关联。
方法 本研究共纳入100例年龄超过18岁、有典型心绞痛症状的患者。这些患者必须进行HRR的平板运动试验和HRV的24小时动态心电图监测。然后这些患者接受有创冠状动脉造影，并将病变严重程度描述为单支血管或两支/三支（多支血管）受累。病变还被分为狭窄<70%和≥70%的病变。研究了病变严重程度与自主神经功能障碍之间的关联。
结果 HRR和HRV值与病情较重的患者相关。多因素回归分析显示，异常HRV与病情较重相关；然而，异常HRR与病变严重程度无直接关联。这些自主神经参数与SYNTAX评分呈负相关。
结论 我们的结果表明，自主神经功能障碍与慢性冠状动脉综合征患者更严重的冠状动脉疾病相关。我们观察到HRR1和HRV与冠状动脉疾病严重程度之间呈负相关。因此，我们可以尝试将这些参数纳入CAD可能性较低患者的筛查中。未来可计划开展研究，观察血运重建后心脏自主神经功能的改善情况及其与预后的关联。
