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Heart rate variability and ischaemia in patients with coronary heart disease and stable angina pectoris; influence of
F Weber1, H Schneider, T von Arnim
1Clinic for Internal Medicine, Cardiology Department, University of Rostock, Germany.
European Heart Journal
|March 13, 1999
Summary
Bisoprolol therapy increased heart rate variability (HRV) in stable angina patients, suggesting a better prognosis. This increase, especially with complete ischemia suppression, indicated significant patient benefit.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacology
Background:
- Stable angina affects numerous patients worldwide.
- Heart rate variability (HRV) is a key indicator of autonomic nervous system function.
- Assessing the impact of cardiovascular therapies on HRV is crucial for understanding prognosis.
Purpose of the Study:
- To determine the influence of bisoprolol and nifedipine on HRV in stable angina patients.
- To evaluate the prognostic value of HRV changes during therapy.
- To identify optimal therapeutic strategies for improving outcomes in ischemic heart disease.
Main Methods:
- Analysis of 422 patients with stable angina from the Total Ischemic Burden Bisoprolol Study.
- 24-hour Holter ECG monitoring to assess HRV parameters.
- Comparison of HRV changes between bisoprolol and nifedipine treatment groups.
Main Results:
- Nifedipine decreased all tested HRV parameters.
- Bisoprolol increased specific HRV parameters, notably the square root of the mean of the squared differences of successive corrected RR intervals.
- An increase in HRV correlated with a tendency towards a better prognosis, with no serious events in patients showing HRV improvement and complete ischemia suppression.
Conclusions:
- Bisoprolol therapy predominantly increased HRV, indicating a favorable prognostic marker.
- Combined increase in HRV and complete ischemia suppression on Holter ECG demonstrated the greatest clinical benefit.
- HRV assessment provides valuable prognostic information in patients with stable angina undergoing treatment.
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