International Journal of Biomedicine. 2021;11(3):260-264.
Originally published September 9, 2021
The purpose of this study was to evaluate the prognostic value of HRV in elderly patients with multivessel coronary artery disease (MVCAD) on the background of invasive and non-invasive treatment.
Methods and Results: This study included 254 patients over age 65 with lesions of the left trunk of the left coronary artery in combination with lesions of 2 or more coronary arteries. To assess HRV, all patients underwent 24-hour Holter ECG monitoring at baseline and one year later. Depending on the treatment strategy, patients were divided into 3 groups. Group 1 consisted of 99 patients who, in addition to the standard treatment, underwent PSI (from 1 to 4 stents); Group 2 included 86 patients who, in addition to the standard treatment, underwent CABG (from 2 to 4 shunts); Group 3 included 69 patients who received only optimal drug therapy (ODT).
The results have shown that a decrease in HRV is an independent predictor of complications associated with an increase in coronary insufficiency in CAD patients. Such indicators of HRV as SDNN, SDNNi, TP, VLF, and LF have a significant positive predictive value in patients undergoing ODF and/or undergoing PCI. For patients undergoing CABG, at least in the first year after surgery, HRV cannot be considered as an independent prognostic marker. For elderly patients with MVCAD, 24-hour Holter ECG monitoring with subsequent analysis of HRV is recommended to assess the recovery process and pharmacotherapy.
- Osodchiy OE, Pokrovsky VM. [Peptide modulation of changes in the duration of the cardiac cycle in vagal sinus arrhythmia]. Kardiologiia. 2000;(2):57-64. [Article in Russian].
- Bekmetova FM, Fozilov KG, Doniyorov S.N. et al. Relationship between the Deformation Properties of the Left Ventricle and the Severity of Coronary Atherosclerosis in Patients with Coronary Artery Disease. International Journal of Biomedicine. 2021;11(2):131-136. doi: 10.21103/Article11(2)_OA1
- Kleiger RE, Miller JP, Bigger JT Jr, Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987 Feb 1;59(4):256-62. doi: 10.1016/0002-9149(87)90795-8.
- Alieva MA, Bulaeva NI, Gromova OI, Golukhova EZ. [Heart rate variability in assessment of the clinical state and prognosis in congestive heart failure]. Creative Cardiology. 2015;9(3):42-55. [Article in Russian].
- Bigger JT Jr, Fleiss JL, Steinman RC, Rolnitzky LM, Schneider WJ, Stein PK. RR variability in healthy, middle-aged persons compared with patients with chronic coronary heart disease or recent acute myocardial infarction. Circulation. 1995 Apr 1;91(7):1936-43. doi: 10.1161/01.cir.91.7.1936.
- Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996 Mar 1;93(5):1043-65.
- Frolkins VV, Verhratsky NS, Shevchuk VG. [Nervous regulation of heart function during aging]. Physiol Journal of the USSR. 1977;63:1134-1143. [Article in Russian].
- Korkushko OV, Pisaruk AV, Khristoforova AM, Lutsik MYu. [Relationship between cardiac arrhythmias and autonomic influences on the heart in elderly patients with chronic ischemic heart disease]. Problemy Stareniia I Dolgoletiia. 1998;(2):140-144. [Article in Russian].
- Geovanini GR, Vasques ER, de Oliveira Alvim R, Mill JG, Andreão RV, Vasques BK, Pereira AC, Krieger JE. Age and Sex Differences in Heart Rate Variability and Vagal Specific Patterns - Baependi Heart Study. Glob Heart. 2020 Oct 21;15(1):71. doi: 10.5334/gh.873.
- Zulfiqar U, Jurivich DA, Gao W, Singer DH. Relation of high heart rate variability to healthy longevity. Am J Cardiol. 2010 Apr 15;105(8):1181-5. doi: 10.1016/j.amjcard.2009.12.022.
- Abhishekh HA, Nisarga P, Kisan R, Meghana A, Chandran S, Trichur Raju, Sathyaprabha TN. Influence of age and gender on autonomic regulation of heart. J Clin Monit Comput. 2013 Jun;27(3):259-64. doi: 10.1007/s10877-012-9424-3.
- Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002 Mar 5;105(9):1135-43. doi: 10.1161/hc0902.104353.
- Mikhailov VM. Heart rate variability: Experience of practical application of the method. Ivanovo, 2000. [In Russian].
- Dubachev A.A. Assessment of heart rate variability in patients undergoing coronary artery bypass grafting. Abstract of PhD Thesis. Kursk, 2012. [In Russian].
- Sokolov SF, Malkina TA. [Clinical significance of assessing heart rate variability]. Heart. 2002;1(2):72-75. [Article in Russian].
- Yavelov IS, Deev AD, Travina EE, Gratsiansky NA. [Predictive value of the average frequency of contractions and heart rate variability, assessed in a short time under standard conditions in the early stages of myocardial infarction]. Kardiologiia. 1999;(6):6-13. [Article in Russian].
- Shaffer F, Ginsberg JP. An Overview of Heart Rate Variability Metrics and Norms. Front Public Health. 2017 Sep 28;5:258. doi: 10.3389/fpubh.2017.00258.
- Erdogan A, Coch M, Bilgin M, Parahuleva M, Tillmanns H, Waldecker B, Soydan N. Prognostic value of heart rate variability after acute myocardial infarction in the era of immediate reperfusion. Herzschrittmacherther Elektrophysiol. 2008 Dec;19(4):161-8. doi: 10.1007/s00399-008-0024-3.
Received July 30, 2021.
Accepted September 1, 2021.
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