scholarly journals The effect of nitroglycerin on cardiac extrasystoles and heart rate variability in patients with ­stable angina pectoris class 1 and 2

2020 ◽  
Vol 101 (5) ◽  
pp. 645-651
Author(s):  
E A Safronova ◽  
A I Kuzin ◽  
U V Kharlamova ◽  
T N Shamaeva ◽  
L V Ryabova
Keyword(s):  
Heart Rate ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Low Frequency ◽  
Exercise Stress ◽  
Stress Tests ◽  
Stable Angina Pectoris ◽  
Ventricular Extrasystoles ◽  
Class 1 ◽  
Low Frequency Waves

Aim. To study the effect of nitroglycerin on the heart rate and its variability in patients with stable angina pectoris class 1 and 2. Methods. 85 men with stable angina pectoris class 1 and 2 pathologies were examined between 2007 and 2012 in the City Clinical Hospital No. 8 of Chelyabinsk (mean age 53.15.66 years). In addition to common methods, a rhythmocardiographic study was performed, which allows you to calculate heart rate variability. An electrocardiogram was recorded simultaneously with the rhythmocardiogram. Results. After sublingual nitroglycerin, the number of ventricular extrasystoles decreased in the background test and during Valsalva maneuver, increased in the Ashner's test and an exercise stress tests and did not change in the orthostatic test. An increase in supraventricular extrasystoles after nitroglycerin administration occurred in 10.6% of patients. Nitroglycerin administration resulted in a decrease in the inter-systolic intervals, an increased in the proportion of slow low-frequency waves statistically significant in the background and an exercise stress test. Spectral indicators of cardiac sympathetic modulation significantly increased in the Ashners test and decreased in the background test, while spectral indicators of cardiac parasympathetic modulation decreased in all samples except in exercise stress tests. Conclusion. Under the influence of nitroglycerin, supraventricular arrhythmias increased in all vegetative tests except for orthostatic, the number/severity of ventricular extrasystoles ambiguously changed: decreased in Valsalva manoeuvre the background test, did not change in orthostatic and increased in Aschner's and an exercise stress tests; after nitroglycerin, the proportions of sympathetic influence (in Ashner's test) and slow low-frequency waves in the spectrum of the vegetative modulation increased with a decrease in parasympathetic.

scholarly journals Stable angina pectoris: choice of therapeutic tactics.

2018 ◽  
Vol 96 (1) ◽  
pp. 78-83
Author(s):  
Andrey A. Kirichenko
Keyword(s):  
Heart Disease ◽  
Angina Pectoris ◽  
Myocardial Ischemia ◽  
Stable Angina ◽  
Documentary Evidence ◽  
Stress Tests ◽  
Stable Angina Pectoris ◽  
Basic Principles ◽  
Transient Myocardial Ischemia ◽  
Positive Effect

In everyday practice, the basic principles of diagnosis and treatment of stable ischemic heart disease, set out in the clinical recommendations, are often not observed. For successful treatment of angina, first of all, it is necessary to verify the diagnosis. The diagnosis of stable angina pectoris can be considered sufficiently justified, provided the characteristic chest pain and documentary evidence of transient myocardial ischemia by stress tests. The patient should be evaluated as a whole, taking into account all existing diseases, since concomitant diseases can directly or indirectly exacerbate the course of coronary heart disease, and sometimes be the main cause of angina. In such cases, treatment of concomitant diseases has a pronounced positive effect on the course of angina pectoris. It is advisable to assess the magnitude of the coronary reserve, the severity and prevalence of transient myocardial ischemia, its impact on hemodynamics and, based on the analysis of these indicators, to identify patients with high or low risk of myocardial infarction. Revascularization brings a clear prognostic benefit only in subgroups at high risk.

scholarly journals Heart rate variability in patients with stable angina pectoris as a risk factor for adverse clinical prognosis: relationship with affective depressive symptoms

2020 ◽  
Vol 11 (4) ◽  
pp. 43-50
Author(s):  
A. O. Lobe ◽  
A. I. Chebotova ◽  
D. N. Ivanchenko ◽  
N. P. Dorofeeva ◽  
A. S. Pleskachev ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Depressive Symptoms ◽  
Treatment Group ◽  
Angina Pectoris ◽  
Stable Angina ◽  
Depressive Disorders ◽  
Stable Angina Pectoris ◽  
Clinical Prognosis ◽  
Affective Symptoms

Objective: to investigate the heart rate variability (HRV) parameters of patients with a stable angina pectoris depending of presence depressive disorders; to identify the influence of affective symptoms on the clinical outcome during 12 months of observation.Material and methods: there are 121 male patients included in research with a stable angina pectoris II – III functional classes, hospitalized for a drug treatment and planned percutaneous coronary intervention (PCI) with stenting. The severity of affective symptoms and HRV are being assessed.Results: patients with depressive symptoms in the conservative treatment group had low SDNN level; patients with psychoemotional disorders in the surgical treatment group had differences by all HRV parameters (SDNN, SDANN, SDNN, rMSSD pNN50). Clinically unfavorable outcome, including intermediate points such as increase in angina attacks, re-hospitalization, stent’s restenosis, were mostly registered during 12 months of observation in the groups with affective symptoms.Conclusions: presence of depressive symptoms of patients with stable angina pectoris is accompanied with low HRV parameters, which is connected with worsening of cardiac prognosis. 

scholarly journals Comparison of the efficacy of Ivabradine and Nebivolol as Mono Therapy in the Treatment of Stable Angina Pectoris Patients with Mild Left Ventricular Dysfunction

2019 ◽  
Vol 15 (1) ◽  
pp. 8-11
Author(s):  
Harisul Hoque ◽  
Khurshed Ahmed ◽  
MRM Mandal ◽  
Faisal Ibn Kabir ◽  
Md Abdus Salam ◽  
...  
Keyword(s):  
Heart Rate ◽  
Chest Pain ◽  
Angina Pectoris ◽  
Left Ventricular Dysfunction ◽  
Stable Angina ◽  
Ventricular Dysfunction ◽  
Left Ventricular ◽  
Stable Angina Pectoris ◽  
Group A ◽  
Group B

This prospective study aimed to investigate the efficacy of ivabradine and nebivolol in treatment of stable angina pectoris (SAP) patients with mild left ventricular dysfunction. Heart rate decreased (78±6) to (65±5) in Group: A and ( 77± 7) to (70 ± 5) in Group: B. There was no change in Blood pressure reduction in Group:A but significant BP reduction in Nebivolol group. Chest pain was reduced by Ivabradine but in Group : B, chest pain decreased in long term after 6 weeks time. After 6 months’ treatment LVEF for the 15 patients of nebivolol group (50%; Group: A) improved by (48 ± 6.5) to (51 ± 3.2), (p>0.05) and for the 15 patients of Ivabradine group (50%; Group: B) (47 ± 5.4) to (51 ± 2.3), (p>0.05). Ivabradine can be considered as first choice in patient with tachycardia induced angina as this agent for reducing heart rate as well as chest pain. The hypertensive patient with tachycardia may be treated by Nebivolol. Among patients in which effective treatment could not be achieved at maximum nebivolol doses, more effective results were obtained in this study with Ivabradine. University Heart Journal Vol. 15, No. 1, Jan 2019; 8-11

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