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

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.

Relation between Major and Minor Depression and Heart Rate, Heart-Rate Variability, and Clinical Characteristics of Patients with Acute Coronary Syndrome

2007 ◽  
Vol 100 (3_suppl) ◽  
pp. 1245-1254 ◽  
Author(s):  
Katija Čatipović-Veselica ◽  
Andrea Galić ◽  
Krešimir Jelić ◽  
Vedrana Baraban-Glavaš ◽  
Sandra Šarić ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Coronary Syndrome ◽  
Clinical Characteristics ◽  
Minor Depression ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

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.

Characteristics of heart rate variability in patients with acute coronary syndrome without ST segment elevation in comparison with clinical and biochemical parameters

2021 ◽  
Vol 29 (3) ◽  
pp. 369-378
Author(s):  
Aleksej A. Nizov ◽  
Aleksej I. Girivenko ◽  
Mihail M. Lapkin ◽  
Aleksej V. Borozdin ◽  
Yana A. Belenikina ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Coronary Syndrome ◽  
Creatine Phosphokinase ◽  
Spectral Power ◽  
Low Frequency ◽  
Heart Rhythm ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

BACKGROUND: The search for rational methods of primary, secondary, and tertiary prevention of coronary heart disease. To date, there are several publications on heart rate variability in ischemic heart disease. AIM: To study the state of the regulatory systems in the organism of patients with acute coronary syndrome without ST segment elevation based on the heart rhythm, and their relationship with the clinical, biochemical and instrumental parameters of the disease. MATERIALS AND METHODS: The open comparative study included 76 patients (62 men, 14 women) of mean age, 61.0 0.9 years, who were admitted to the Emergency Cardiology Department diagnosed of acute coronary syndrome without ST segment elevation. On admission, cardiointervalometry was performed using Varicard 2.51 apparatus, and a number of clinical and biochemical parameters were evaluated RESULTS: Multiple correlations of parameters of heart rate variability and clinical, biochemical and instrumental parameters were observed. From this, a cluster analysis of cardiointervalometry was performed, thereby stratifying patients into five clusters. Two extreme variants of dysregulation of the heart rhythm correlated with instrumental and laboratory parameters. A marked increase in the activity of the subcortical nerve centers (maximal increase of the spectral power in the very low frequency range with the underlying reduction of SDNN) in cluster 1 was associated with reduction of the left ventricular ejection fraction: cluster 147.0 [40.0; 49.0], cluster 260.0 [58.0; 64.0], cluster 360.0 [52.5; 64.5] % (the data are presented in the form of median and interquartile range; Me [Q25; Q75], p 0,05). Cluster 5 showed significant reduction in SDNN (monotonous rhythm), combined with increased level of creatine phosphokinase (CPC): cluster 5446,0 [186.0; 782.0], cluster 4141.0 [98.0; 204.0] IU/l; Me [Q25; Q75], p 0.05) and MВ-fraction of creatine phosphokinase; cluster 532.0 [15.0; 45.0], 4 cluster 412.0 [9.0; 18.0] IU/l; Me [Q25; Q75], p 0.05). CONCLUSIONS: In patients with acute coronary syndrome without ST segment elevation, cluster analysis of parameters of heart rate variability identified different peculiarities of regulation of the heart rhythm. Pronounced strain of the regulatory systems of the body was found to be associated with signs of severe pathology: the predominance of VLF (spectral power of the curve enveloping a dynamic range of cardiointervals in the very low frequency range) in spectral analysis with an underlying reduced SDNN is characteristic of patients with a reduced ejection fraction, and a monotonous rhythm is characteristic of patients with an increased level of creatine phosphokinase and MB-fraction of creatine phosphokinase.

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