Correlation Between Heart Rate Variability And Cardiac Function And The Progress Of Non-stent Vascular Lesions In Patients With Coronary Heart Disease After Percutaneous Coronary Intervention

Objective:For coronary heart disease(CHD)patients with non-stent vascular disease progress after percutaneous coronary intervention(PCI),we analyze the relationship between heart rate variability(HRV)and heart function on the progression of non-stent vascular lesions.We intend to provide early noninvasive means to find the patients whose non-stent vascular lesions pathological changes after PCI,and then a theoretical basis for guiding clinical early intervention.Methods:Total of 149 CHD patients who review CAG after PCI for 6 months or more from the Second Clinical Hospital of Shanxi Medical University during January 2013 to October 2017 were enrolled.At the age of 36-81 years old,the average age was 61.30 + 10.09 years old,including 112males(75.2%),mean age 59.29±9.99 years,37 females(24.8%),mean age 67.35±7.78 years.All patients were divided into non-stent vascular disease progression group(n = 45)and non-progression group(n = 55)based on the results of CAGs and non-stent vascular lesions.Patient data including sex,age,hypertension,hyperlipidemia,diabetes,coronary angiography coronary lesions,24 hours ambulatory electrocardiogram results,cardiac function related indicators were entered into the computer database.SPSS22.0 was used to data analysis,to study correlation between heart rate variability and cardiac function index changes and the progress of non-stent vascular lesions in patients with coronary heart disease after percutaneous coronary intervention.Results: 1.After PCI,149 CHD patients were grouped according to the results of re coronary angiography,including 45 cases(30.2%)of non-stent vascular lesions progression group and 104 cases(69.8%)of non-stent vascular disease non-progression group.There was no significant difference in gender,age,hypertension,diabetes,hyperlipidemia or mean heart rate between the progressive group and the non progressive group(P>0.05).2.The non-stent vascular disease progression group of coronary heart disease patients after PCI,HRV in SDNN,SDNN index,RMSSD and PNN50 were significantly lower than those in non-progression group(P<0.05);there was no significant difference between coronary heart disease patients after PCI the non-stent vascular disease progression group in different disease progression number(P>0.05);negative correlation was found between the HRV and the degree of progression and stenosis in non-stent vascular disease progression group of coronary heart disease patients after PCI,and the SDNN,SDNN index,RMSSD and trigonometric index in severe stenosis group were significantly lower than those in mild stenosis group(P<0.05).3.For non-stent vascular disease progression group of coronary heart disease patients after PCI,the cardiac function indexes in Aortic root diameter(AO),left ventricular end-diastolic diameter(LVD),left ventricular end-systolic volume(LESV),left ventricular end-diastolic volume(LEDV)were significantly higher than those non-progression group(P<0.05);there was a significant difference in non-stent vascular disease progression group of single coronary artery lesion group and multi vessel disease group,double vessel group and multi vessel group in echocardiography cardiac function indexes in left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LESV),left ventricular end-diastolic volume(LEDV)(P<0.05);positive correlation was found between the cardiac function indexes in left ventricular end-diastolic diameter(LVD),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)and the degree of progression and stenosis in non-stent vascular disease progression group of coronary heart disease patients after PCI,and in severe stenosis group those indexes were significantly higher than the mild stenosis group,the difference was statistically significant(P<0.05).Conclusion: 1.The rate of progression of non-stent vascular disease in patients with coronary heart disease after PCI is relatively high(about 30%).Therefore,it is significant to attach the screening of disease relate risk factors and the mechanism of disease progression to find predictable factors.2.The lower the HRV in patients with coronary heart disease after PCI,the more serious the progression of non-stent vascular lesion is.In heart rate variability parameters,SDNN,SDNN index,RMSSD,PNN50,TRI is sensitive indicators to reflect the impaired autonomic function,and SDNN,SDNN index,RMSSD decreased can be used as an important index to predict the non-stent vascular disease progression and the degree of stenosis of coronary heart disease patients after PCI.3.The progression of non-stent vascular disease in patients with coronary heart disease after PCI is more serious,and the decrease of cardiac function is more obvious.The regular monitoring of echocardiogram cardiac function index LVD,LVESV and LVEDV is helpful to predict and judge the degree of stenosis.4.In clinical,24 hours ambulatory electrocardiogram and echocardiography noninvasive examination are performed for patients with coronary heart disease after PCI.Reference heart rate variability and cardiac function index are helpful for early prediction of progression of non-stent vascular disease progression.