Study On Heart Rate Variability And Coronary Artery Disease Degree In Patients With Coronary Heart Disease Complicated With Abnormal Glucose Metabolism

Objective: To study the effects of different levels of glucose metabolism on the severity of coronary artery disease in patients with coronary heart disease,and to analyze the correlation between the changes of heart rate variability and the severity of coronary artery disease in patients with coronary heart disease and abnormal glucose metabolism.Methods: From November 2017 to October 2018,111 patients with coronary artery disease were examined by coronary angiography in Affiliated Hospital of Qinghai University.According to OGTT,111 patients with coronary heart disease were divided into simple coronary heart disease group(CHD,n = 33 cases),impaired blood glucose regulation group(CHD + IGR,n = 41 cases),diabetes group(CHD + DM,n = 37 cases),according to the different blood sugar levels of the three groups.The degree of coronary artery disease was correlated with the degree of coronary artery disease.At the same time,24-hour ambulatory electrocardiogram was used to detect the index of heart rate variability,reflecting the impaired balance function of autonomic nervous system to evaluate the degree of coronary artery disease.Results: 1.There was no significant difference in sex,smoking history,age,TC,TG,LDL-C,HDL-C,UA and Hcy among the three groups(P > 0.05).2.There were statistical differences in SDNN and Gensini scores among three groups of patients with coronary heart disease(P = 0.000).3.Gensini score in the impaired group was positively correlated with postprandial 2-hour blood glucose(r = 0.946 P = 0.000),and Gensini accumulation in the diabetic group was positively correlated with postprandial 2-hour blood glucose(r = 0.946 P =0.000)The scores were positively correlated with blood sugar 2 hours after meal(r = 0.944 P = 0.000).4.There was significant difference between the number of coronary artery lesion branches and blood sugar in different levels(P=0.000)5.Bivariate correlation analysis showed that Gensini score was negatively correlated with SDNN(r=-0.953 P=0.000),and negatively correlated with SDANN(r=-0.888 P=0.000).6.Multiple linear regression analysis of Gensini integral value shows that and SDANN are independent predictors of Gensini integral level,and the influence of SDANN on Gensini integral value is greater than that of SDANN.Conclusion: 1.With the increase of blood sugar,the severity of coronary arterylesions in patients with abnormal glucose metabolism significantly aggravated the number of lesion branches increased.2.SDANN is negatively correlated with Gensini score,which is an independent predictor of Gensini score level and can be used as one of the effective indicators to evaluate the progress of coronary artery disease.3.The influence of SDNN on Gensini integral value is greater than that of SDANN.