Randomized control trial investigating the influence of coffee on heart rate variability in patients with ST-segment elevation myocardial infarction

This study examined the prevalence of major and minor depression in patients with acute coronary syndrome and their relation with heart rate and heart-rate variability, and clinical characteristics. The study group included 297 patients, 200 men and 97 women, between ages of 21 and 70 years ( M age = 57.5 ± 9.6), who were admitted to a coronary care unit with acute coronary syndrome and survived to discharge from the hospital. Major and minor depression were diagnosed using DSM-IV. There were 44.1% patients with acute coronary syndrome without depression, 29.3% with minor depression, and 26.6% with major depression. The prevalence of minor and major depression was more elevated in patients with non-ST-segment elevation myocardial infarction and unstable angina than in patients with ST-segment elevation myocardial infarction. Ventricular fibrillation and atrial fibrillation were more common in patients with major and minor depression than in patients without depression. The 24-hr. duration of heart-beat intervals and heart-rate variability were significantly lower in patients with major and minor depression than in patients without depression. This study implies that clinical depression was significantly comorbid with the acute coronary syndrome and was related to hypertension, diabetes mellitus, age, sex, type of acute coronary syndrome, left ventricular failure, higher heart rate, and lower heart-rate variability.

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ESTIMATION AND PROGNOSTIC VALUE OF THE PATIENTS SIMPATOVAGAL STATUS IN THE ACUTE PERIOD OF MYOCARDIAL INFARCT WITH ST SEGMENT ELEVATION

Siberian Medical Journal ◽

10.29001/2073-8552-2018-33-4-90-97 ◽

2019 ◽

Vol 33 (4) ◽

pp. 90-97

Author(s):

V. E. Oleynikov ◽

E. V. Dushina ◽

M. V. Lukyanova ◽

Yu. A. Barmenkova ◽

I. Y. Moiseeva

Keyword(s):

Myocardial Infarction ◽

Heart Rate ◽

Heart Rate Variability ◽

Heart Rhythm ◽

Heart Rhythm Variability ◽

St Segment Elevation ◽

Reactive Protein ◽

Segment Elevation Myocardial Infarction ◽

Normal Heart Rate ◽

St Segment

The aimof the study was to analyze the impact of the status of cardiac autonomic nervous regulation on the fragmentation activity, development and progression of heart failure, and the long-term prognosis in patients with early ST segment elevation myocardial infarction.Material and Methods. The study included 143 subjects; 54 healthy volunteers were examined to identify normal values of heart rhythm variability parameters. The observation group comprised 89 patients with ST segment elevation myocardial infarction who underwent 24-hour ECG monitoring at day 7 to 9 as well as at 24 and 48 weeks with follow up assessment of heart rate variability and late ventricular potentials. At the time points, the levels of brain natriuretic peptide and highly sensitive C-reactive protein were determined. Patients underwent a 6-min walk test every 12 weeks. The development of repeated cardiovascular events has been monitored as an end-point. Patients were assigned to two groups according to results of heart rhythm variability analysis at day 7–9 after onset of ST segment elevation myocardial infarction: group 1 had normal heart rate variability; group 2 had increased sympathetic impact on rhythm.Results. In group 1, a pronounced regression of the brain natriuretic peptide level was registered 24 week after onset of ST segment elevation myocardial infarction. The value of C-reactive protein decreased in all groups. A favorable transformation of the indices reflecting the fragmentation activity — high-frequency low-amplitude and root mean square — of the myocardium was recorded only in the group with normal heart rate variability parameters. The risk of repeated cardiovascular events during 48 weeks after ST segment elevation myocardial infarction was significantly higher in the group with dominant sympathetic activity than in the group with normal status of the autonomic nervous system.Conclusion. Hypersympathicotonia in the acute period of ST segment elevation myocardial infarction was associated with an increased relative risk of repeated cardiac events and negatively affected the dynamics of laboratory parameters indicative of heart failure development and progression.

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