Study On The Relationship Between The Syndrome Of Stable Angina Pectoris And Autonomic Nervous Function Based On Analyzing Heart Rate Variability

Objective:By observing the change of time domain,frequency domain,nonlinear parameters(complexity,approximate entropy and correlation dimension)of heart rate variability in different excess/deficiency syndromes(ES/DS)of stable angina pectoris(abbreviated as SAP),the trends and differences of autonomic nerve function status,chaos characteristics and dynamic changes in day and night in Excess/Deficiency syndromes have been analyzed from different dimensions and angles,with aims to explore the relationship between TCM syndrome and autonomic nerve function.Methods:A total of 231 patients with SAP were involved in this study.According to TCM syndrome differentiation criteria,all patients with SAP were divided into three groups:those with the excess syndrome(42 cases,18.18%),with the deficiency syndrome(48cases,20.78%),and with the syndrome of intermingled deficiency and excess(141 cases,61.04%).24 hours Electrocardiogram(abbreviated as ECG)signals of study subjects were collected by using the American DMS dynamic electrocardiogram recorder,to calculate the all-day time domain and frequency domain and complexity,approximate entropy and correlation dimension indexes.All ECG signals were decomposed into different frequency bands using wavelet transform technology,which include high frequency(HF),low frequency(LF),very low frequency(VLF),and ultra low frequency(ULF).Then calculated separately the hourly complexity,approximate entropy,and correlation dimension in a continuous 24 hours of the whole day in 5 different frequency bands(full frequency bands,HF,LF,VLF,and ULF).SPSS19.0 statistical software was used to analyze the characteristics of autonomic nervous system function,chaos degree and its day and night dynamic variation trends of different patients with ES/DS by means of using variance analysis,non-parametric test and repeated measurement of variance analysis.Results:(1)The autonomic nerve function status of patients with SAP ES/DS was:(1)The patients with ES were not accompanied by obvious autonomic nerve function injury,and patients with DS had obvious autonomic nerve function injury.Compared with the ES,the total energy of the autonomic nerve function,vagus nerve tension and sympathetic nerve tension of the DS patients were significantly reduced.② During the evolution of syndromes,when the "excess syndromes "was transformed into" the syndrome of intermingled deficiency and excess(abbreviated as intermingled ES/DS)",the autonomic nerve function was reduced,in which the vagus nerve tension and sympathetic nerve tension were both weakened,may be mainly damaged by the vagus nerve tension.When the syndromes changing from the " intermingled ES/DS"to "deficiency syndromes",the autonomic nerve tension decreased,may be mainly reduced by the sympathetic nerve activity.(2)The chaos characteristics of patients with SAP ES/DS were:① the chaotic complexity of SAP ES/DS showed that the ES was the largest,the intermingled ES/DS is the second,and the DS was the smallest.With the illness aggravating,syndromes changing from the "excess" to "deficiency",the complexity gradually reduced,the degree of chaos gradually reduced.② in the full frequency bands,the distribution of the complexity and correlation dimension curves among the three groups were both presented as the ES group>intermingled ES/DS group>DS group.③ in the HF band,the distribution of the complexity and approximate entropy curves among the three groups were both presented as the ES group>intermingled ES/DS group≈ DS group.④ in the LF band,the distribution of the complexity curve among the three groups was presented as the ES group>intermingled ES/DS group≈ DS group.The distribution of the correlation dimension curve among the three groups was presented as the ES group>intermingled ES/DS group>DS group.⑤ in the VLF band,the distribution of the complexity and correlation dimension curves among the three groups were both presented as the ES group>DS group.⑥ in the ULF band,the distribution of the approximate entropy curve among the three groups was presented as the ES group>intermingled ES/DS group>DS group.(3)The day and night dynamic trends of the non-linear characteristics of SAP ES/DS were:except the LF band,the day and night dynamic change trends of the non-linear features of SAP ES/DS were consistent.Conclusion:(1)The ES patients with no significant autonomic nerve injury,the DS patients with significant autonomic nerve injury.Compared with the ES,the total energy of the autonomic nerve function,vagus nerve tension and sympathetic nerve activity were significantly reduced in the DS patients.(2)During the evolution of syndromes,when the "excess syndromes" was transformed into "intermingled ES/DS",the autonomic nerve function was reduced,in which the vagus nerve tension and sympathetic nerve activity were both weakened,may be mainly damaged by the vagus nerve tension.When the syndromes changing from the" intermingled ES/DS "to"deficiency syndromes",the autonomic nerve tension decreased,may be mainly reduced by the sympathetic nerve activity.(3)The results of the analysis of the non-linear indicators suggest that the chaotic characteristics of the ES are more obvious than the DS and the DS is more likely to be accompanied by the attenuation and loss of the chaotic characteristics of the human body.This is in line with the definition of disease and poor prognosis in the field of current nonlinear research.(4)The results of this study show that the three indexes(complexity,approximate entropy and correlation dimension)all show that the ES was the largest,and the DS was the smallest.And the results of nonlinear parameters are supported by the observation results of time domain and frequency domain.