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Changes and short-term prognostic prediction value of short-time heart rate variability in patients with acute coronary syndrome after percutaneous coronary intervention |
ZANG Aoqi, WANG Lichao, XUAN Ling, ZHANG Heng |
Department of Cardiovascular Medicine, the First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233000, China |
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Abstract Objective To investigate the changes of short-time heart rate variability (HRV) in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), and to discuss the value of HRV indexes in predicting their short-term prognosis. Methods We selected 76 patients who had undergone PCI therapy. They were grouped by the presence or absence of major adverse cardiac events (MACE) within 6 months after PCI. Those patients without MACE were classified into the control group (55 cases) while those with MACE were set as the research group (21 cases). HRV linear indexes of SDNN, rMSSD, LF and HF, and HRV nonlinear indexes of approximate entropy (ApEn), sample entropy (SampEn) and Poincaré scatterplot indexes of SD1 and SD2 were compared between the two groups after PCI. Changes of HRV indexes before and after PCI were compared. Coronary artery Gensini scoring was performed in all the patients. Correlation analysis was made between coronary artery Gensini score and HRV indexes after PCI. Following up for half a year, we explored the risk factors of MACE by binary Logistic linear regression of the incidence of MACE and HRV indexes. Results In the research group SDNN, LF and SD2 are significantly increased compared with those in the control group (P<0.05) while rMSSD and SD1 are significantly decreased (P<0.05); HF, ApEn and SampEn do not vary sig nificantly from those in the control group (P>0.05). The indexes of SDNN, rMSSD, LF, HF, SD1 and SD2 after PCI are all significantly lower than those before PCI (P<0.05) while ApEn and SampEn show no significant difference before and after PCI (P>0.05). Pearson correlation analysis shows that coronary artery Gensini score of patients is unrelated to SDNN, rMSSD, LF, HF, SD1, SD2 and ApEn (P>0.05). Binary Logistic regression analysis reveals that LF and SD2 are risk factors of MACE (P<0.05). Conclusion Autonomic modulation is improved in ACS patients after PCI. HRV indexes of LF and SD2 could effectively reflect the short-term prognosis after operation.
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