Parameters of Autonomic Nervous System Dysfunction in Acute and Chronic Forms of Ischemic Heart Disease

The aim of the investigation was to determine the clinical significance of novel parameters of heart rate variability in patients with acute myocardial infarction and chronic ischemic heart disease.

Materials and Methods.The study included 83 male patients, who were divided into three groups: group 1 comprised 30 people with the diagnosis of acute coronary syndrome resulted in myocardial infarction; group 2 consisted of 30 patients with chronic forms of ischemic heart disease; control group 3 included 23 apparently healthy persons without any changes in ECG. ECG signal was recorded using certified computer-based EC-01 electrocardiograph (Novye Pribory, Samara). These records were processed using MATLAB applied program package. The following heart rate variability indices of ECG monitoring at rest and during exercise (6-minute walk test) were analyzed: SDNN, RMSSD, LF/HF ratio, fractal exponent α, the total spectral power, acceleration/deceleration (AC/DC) capacity of the heart rate.

Results. The 6-minute walk test leads to unidirectional heart rate variability reduction in both healthy persons and patients with cardiac diseases. As a result, differences in heart rate variability indices between the groups, which were observed at rest, disappear during exercise, except for significantly reduced SDNN and total spectral power value in patients with acute myocardial infarction. A decrease in fractal properties of the heart rate was revealed in patients with coronary artery disease and myocardial infarction on short-term ECG recordings (fractal exponent α), which was independent of physical activity.

Conclusion. When studying the dysfunction of the autonomic nervous system, new parameters reflecting deceleration (DC) and acceleration (AC) of heart rate variability at rest, fractal exponent α independent of physical activity, as well as SDNN and the total spectrum power should be considered along with the classical RMSSD index.

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Akulova A.S., Fedotov A.A., Kolmakova K.M., Gracheva A.I., Lebedev P.A. Parameters of Autonomic Nervous System Dysfunction in Acute and Chronic Forms of Ischemic Heart Disease. Sovremennye tehnologii v medicine 2017; 9(2): 162, https://doi.org/10.17691/stm2017.9.2.21