Norepinephrine And Heart Rate Variability And Coronary Heart Disease Combined With Anxiety Disorders

Background:In recent years, with the rapid development of social economy, theconstant improvement of people’s living standard, the incidence ofcoronary heart disease and mortality in China is rapidly rising trend,severely reducing the people’s life quality, has become one of the mostimportant diseases that threaten people’s health. Modern medical modelfrom the biomedical model originally pure gradually to the psychologicalpattern of medicine biology society change, psychological factors havebeen widely used in the factor of CHD etiology, course and prognosis.Anxiety is one of the most common in patients with coronary heartdisease complicated with mental illness, but coronary heart diseasecomplicated with anxiety attaches great importance to clinicians have notbeen fully in clinic, the doctor in the process of diagnosis and treatment inpatients with coronary heart disease often only pay attention to theorganic disease and neglect the psychological disease such as anxietyexists, at the same time, patients and family members also did notexplicitly recognize Association and the harm of the two kinds of diseases.At present, access to a large number of documents found by domestic andforeign scholars on coronary heart disease and anxiety in relation to themore concentrated in the effects of anxiety on the prognosis of patientswith coronary heart disease, and in coronary patients with anxietydisorder research report changes in neuroendocrine metabolism were rare,this study by determination of norepinephrine and heart rate variability index, to explore the relationship between the changes of neuroendocrineand coronary heart disease in patients with anxiety disorder, and provide atheoretical basis for the treatment of anxiety in patients with coronaryheart disease complicated with nerve endocrine abnormalities, but alsofor the early intervention of coronary heart disease complicated withanxiety excited sympathetic nerve to prevent disease progression andprovide new ideas.Objective:By measuring the coronary heart disease patients complicated withanxiety in blood levels of noradrenaline and heart rate variability, toexplore the relationship between the changes of neuroendocrine andcoronary heart disease in patients with anxiety disorder, and provide atheoretical basis for the treatment of anxiety in patients with coronaryheart disease complicated with nerve endocrine abnormalities, and earlyintervention of coronary heart disease with anxiety disorders sympatheticexcited to prevent the disease progress with new ideas.Method:The subject from2011September-2012year in December visits forcardiovascular department of internal medicine of our hospital patients,was received12leads ECG, blood and urine routine, biochemical,norepinephrine, selective determination of myocardial markers,24hourdynamic electrocardiogram, echocardiography, coronary arteriographyand Hamilton Anxiety Scale (HAMA) score, according to determinationresults of the project analysis and group: A group (coronary heart diseasepatients with anxiety disorder group), group B (coronary heart diseasewithout anxiety group), group C (anxiety group without coronary heartdisease), group D (healthy control group without coronary heart disease and anxiety group). Determination of norepinephrine levels and heart ratevariability in plasma, and the use of SPSS13.0statistical software toanalyze all the data.Results:(1) Showed no statistically significant difference in group A, groupB, group C, group D between four groups in gender, age, hypertension,cholesterol, low density lipoprotein cholesterol, high density lipoproteincholesterol, triglyceride index difference (P>0.05);(2) and D group(healthy control group without coronary heart disease and anxietydisorders group) norepinephrine levels to normal, the A group (coronaryheart disease and the anxiety group) norepinephrine levels compared withgroup D levels were significantly uphigh and statistically significant (P<0.05). Group B (coronary heart disease is not associated with the anxietygroup), elevated norepinephrine levels compared with the level of GroupD of the C group (without coronary heart disease, anxiety disorder group),but not statistically significant (P>0.05);(3) D group (healthy controlgroup without coronary heart disease and anxiety disorders group) theSDNN, rMSSD and PNN50value A group (coronary heart disease andthe anxiety group) the SDNN, rMSSD and PNN50significantly lowervalue than the value of group D, with statistical significance (P <0.05).Group B (coronary heart disease is not associated with the anxiety group),group C (without coronary heart disease, anxiety disorders group) SDNN,rMSSD and PNN50value reduced than the value of the D group, but notstatistically significant (P>0.05).Conclusion:(1) The results of this experiment show norepinephrine in the blood of patients with coronary heart disease and anxiety disorders weresignificantly increased, prove that occur of norepinephrine increasedmetabolism and coronary heart disease in patients with anxiety disorders,the development of a very close relationship, suggesting that it isnecessary in patients with coronary heart disease and anxiety disordersand treatment of neuroendocrine;(2) the results of the present study inpatients with coronary heart disease and anxiety disorders decreased heartrate variability, the SDNN, rMSSD and PNN50values were significantlylower,confirmed the presence of increased sympathetic activity in patientswith coronary heart disease and anxiety disorders, functions and tensionof the vagus nerve damage;(3) coronary heart disease and anxietydisorders, body of neuroendocrine function imbalance.