Effect Of Stage ? Cardiac Rehabilitation On Cardiac Autonomic Function After PCI In Patients With Coronary Heart Disease

Purpose:The number of people dying from cardiovascular disease worldwide accounts for about one-fifth of the total number of deaths.,coronary heart disease is the most common cardiovascular disease in the clinic.Cardiac autonomic dysfunction is one of the risk factors for coronary heart disease and is associated with increased morbidity and mortality [1].Heart rate variability [2] refers to the small difference in the inter-trial interval,the R-R interval,caused by the modulation of the autonomic nervous system on the sinus node of the heart,resulting in tens of milliseconds of difference and fluctuation in the duration of the heartbeat interval.This is one of the most common non-invasive diagnostic methods for assessing autonomic dysfunction and has been shown to be a predictor of postoperative risk of PCI in patients with myocardial infarction [3].Percutaneous coronary intervention(PCI)has become one of the effective treatments for patients with coronary heart disease.The revascularization of PCI can reduce the state of sympathetic overactivity and restore normal cardiac autoregulation.At the same time,cardiac rehabilitation has been shown to significantly improve the patient's cardiac load capacity,reduce the risk of cardiovascular disease,and improve autonomic nervous regulation [3].It also makes cardiac rehabilitation in patients with coronary heart disease after PCI important.We selected patients with coronary heart disease after PCI and guided their cardiac exercise rehabilitation to observe the cardiac rehabilitation to improve the patient's autonomic nerve function,and guide patients to better return to society.Methods:A total of 160 patients with PCI who were admitted to the Department of cardiovascular medicine in Jiangsu Subei People's Hospital(affiliated with Yangzhou University)from January 2018 to January 2019 were selected?Inform the experimental procedure,collect personal body indicators,medical history,risk factors,etc.According to the random number table,we divided the patients into a control group and observation group:the experimental group(n=80): routine postoperative treatment + routine nursing + rehabilitation exercise group;control group(n=80): routine postoperative treatment + routine care group.Both groups monitored the ECG of the patient within 24 hours after surgery and through the wearable dynamic electrocardiograph Cre Yond CY-HR-01,and recorded the heart rate variability index.Heart rate variability was measured again one week later.Heart rate variability indicators include: SDNN,r MSSD,p NN50,etc.Adverse events were recorded in each group at 1 month and 6 months after PCI.All data were analyzed by SPSS 20.0 software.When p less than 0.05,the difference between the date was considered statistically significant.Results:1.Comparison of basic data between the two groups of patients:The selected 160 patients were eligible for the WHO diagnostic criteria,and the diagnosis was coronary heart disease,including 103 males and 57 females,accounting for 64.4% and 35.6% of the total;the age range was 25-75 years,and the average age was 61.5�12.43 years old.The control group:n=80,the experimental group:n=80.There were no significant differences in gender,smoking history,alcohol history,hypertension,diabetes,and dyslipidemia between the two groups.2.There were no significant differences in BMI,white blood cells,hs-CRP,c Tn I,NT-Pro BNP,FIB,and D-D between the two groups before and after the experiment.3.There was no significant difference in triglyceride and total cholesterol between the two groups before treatment(P>0.05).After treatment,the levels of total cholesterol(TC)and triglyceride(TG)were slightly decreased,There were no significant changes in(LDL-C)and high-density lipoprotein cholesterol(HDL-C)levels,and the lipid of patients in the experimental group was significantly lower(p>0.05).4.There was no significant difference in glycated hemoglobin(p>0.05).After treatment,the fasting blood glucose(FDG)levels of the two groups were lower than before,and the FDG of the experimental group was significantly lower,the difference was statistically significant(p<0.05).5.Comparison of heart rate variability results: Both groups of patients were monitored by the wearable dynamic electrocardiograph Cre Yond CY-HR-01 to record the patient's heart rate variability.Before and after the experiment,the SDNN,r MSSD,and p NN50 of the experimental group were higher than the previous ones,and the difference was statistically significant(p<0.05).There were no significant changes in the heart rate variability indexes of the control group(p>0.05).After the experiment,the experimental group was significantly higher than the control group,SDNN,r MSSD,p NN50,and the difference was statistically significant(p<0.05).6.The comparison of the happen of MACEs incidengt.The incidence of total MACEs,including angina pectoris,malignant arrhythmia,heart failure,sudden death and so on.One month after operation: 1 case in the experimental group and 5 cases in the control group;6 months after operation: 5 cases in the experimental group and 16 cases in the control group;The difference was statistically significant(P<0.05).Conclusion: 1.Cardiac rehabilitation can improve heart rate variability and improve cardiac autonomic function in patients with coronary heart disease.2.Patients with coronary heart disease undergoing cardiac rehabilitation(education,exercise)after PCI can significantly improve their metabolic equivalents,improve cardiac function,control risk factors,and reduce the occurrence of MACE events.3.Fasting blood glucose levels were negatively correlated with heart rate variability,suggesting that cardiac autonomic function has been impaired during the stage of impaired glucose regulation.4.The early rehabilitation involved in the current study is the sum of Phase I and Phase II.This study distinguishes Phase I rehabilitation from Phase II rehabilitation,highlighting the content,results,and significance of Phase I rehabilitation.