| Objective: The aim of this study was to further explore the characteristics of Coronary lesion degree of stenosis,the influence of different narrow parts of HRV,through the study of Coronary heart disease(CHD)in patients with heart rate variability(HRV).By studying the characteristics of HRV in patients with the Percutaneous coronary interention(PCI)surgery,to realize the impact of PCI surgery for HRV.Method:A total of 156 patients with coronary artery disease who underwent coronary angiography or PCI were enrolled from September 2016 to March2017 in the Department of cardiovascular medicine,the Second Hospital of Hebei Medical University.There were 90 males,with an average age of(59.22±8.36)and 66 females,with an average of(59.63±9.02).Information collected included gender,age,hypertension,diabetes and hyperlipidemia.All the patients were followed up by dynamic electrocardiogram(HRV)before 12 huors coronary angiography.The time domain indexes of SDNN(ms),RMSSD(ms)and p NN50(%)and the frequency domain indexes of LF,HF and LF/HF were collected.Determine of plasma concentration of renin,angiotensin and aldosterone.Left ventricular end diastolic diameter(LV mm)and left ventricular ejection fraction(EF%)in echocardiography were also collected in hospitalized patients.According to the results of coronary angiography,the patients were divided into two groups: coronary atherosclerosis group and coronary heart disease group(At least one vessel stenosis >50%).24 huors after coronary angiography and PCI,HRV was measured again under the same condition and was observed in its changes and characteristics.To compare the effects of different parts of coronary arterystenosis on HRV,the patients with single lesion were divided into the anterior descending lesion group and the non-anterior descending lesion group,according to the results of coronary angiography.Statistical analysis was performed by SPSS 20.0 software.All these results were expressed as the mean ± standard deviation.Count data was expressed as percentages.Comparison of measurement data between groups using t test,using the analysis of variance with many groups.Enumeration data were compared by the χ2 test.P <0.05 was statistically significant.Results:1 Comparison of coronary atherosclerosis group(31patients)and coronary heart disease group(125 patients): there was not significantly different in gender and history of hypertension,diabetes,hyperlipidemia and the average heart rate(P >0.05)and there was significantly different in age,low frequency,high frequency,low frequency/high frequency,SDNN(MS),RMSSD(MS)and p NN50(%)(P<0.05).2 A total of 60 patients with single vessel lesions were included.Comparison of anterior descending branch group(41 patients,68.33%)and non-anterior descending branch group(19 patients,31.67%): there was not statistically different in gender,age,average heart rate and history of hypertension,diabetes and hyperlipidemia(P >0.05).And there was statistically different in low frequency,high frequency,low frequency/high frequency,SDNN,RMSSD and p NN50(P <0.05).3 There was a statistical difference in the index of heart rate variability(P< 0.05)in patients with single lesion,twin lesions,and 3 lesions.There was no statistical difference(P > 0.05)in the variation of heart rate variability in single lesion group and two branches.There were statistical differences(P <0.05)in patients with single lesion and 3 lesions.4 Before and after PCI: there was not significantly different(P >0.05)in high frequency and there was statistically different(P <0.05)in low frequency,low frequency/high frequency,SDNN,RMSSD and p NN50.Conclusion:Compared with non-CHD patients,the heart autonomic nervous function of CHD patients is reduced.heart rate variability is reduced,and the heart rate variability to reduce not only related to scope of vascular stenosis,and associated with narrow area.PCI opening blood vessels,improving blood flow,removing cardiac autonomic neuromodulation,may improve the prognosis of the patient. |
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