选择性经皮腔内冠状动脉成形术(PTCA)对冠心病患者心率变异性的影响

Anahita R. Shenoy Basti
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摘要

冠状动脉疾病(CAD)是印度的一个主要公共卫生问题,也是导致死亡和发病的主要原因之一。在CAD患者中观察到心率变异性(HRV)受损。经皮冠状动脉腔内成形术(PTCA)是CAD的常见治疗方式之一。在本研究中,我们研究了成功的选择性PTCA对CAD患者HRV参数的影响。材料与方法:对30例男性患者PTCA术前、术后1天和3天的HRV时域和频域参数进行研究。结果:PTCA前和PTCA后第1天的时域和频域参数没有统计学意义。时域参数rMSSD和SDNN在PTCA前和术后第3天之间的变化具有统计学意义,但在pNN50中没有观察到显著差异。在PTCA术前和术后第3天观察到LF n.u的显著降低和HF n.u的增加。结论:PTCA血管重建术可改善自主神经张力。自主神经调节的改善可在PTCA术后第3天观察到。这表明恢复血流在一定程度上逆转了冠状动脉疾病的自主调节作用。
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Impact of Elective Percutaneous Transluminal Coronary Angioplasty (PTCA) on Heart Rate Variability in Patients with Coronary Artery Disease
Coronary artery disease (CAD) is a major public health problem in India and is one of the leading causes of mortality and morbidity. Impairment of heart rate variability (HRV) has been observed in patients with CAD. Percutaneous transluminal coronary angioplasty (PTCA) is one of the common modalities of treatment of CAD. In this study we have studied the effect of successful elective PTCA on HRV parameters in patients with CAD. Material and Method: HRV parameters in both time and frequency domain were studied in 30 male patients before PTCA, one day and three day after PTCA. Results: - The time and frequency domain parameters between pre PTCA and 1 st day post PTCA were not found to be statistically significant. Changes in the time domain parameter rMSSD and SDNN was statistically significant between pre and 3 rd day post PTCA but no significant difference was observed in pNN50. A significant decrease in LF n.u and increase in HF n.u was observed between pre and 3 rd day post PTCA. Conclusion: Revascularization with PTCA results in improvement of the autonomic tone. Improved autonomic modulation is seen as early as 3 rd day post PTCA. It indicates that restoring the blood flow reverses to some extent the autonomic modulatory effect of coronary artery disease.
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