[Dynamics of heart rate variability in ischemic heart disease patients after coronary artery bypass grafting]
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Published on: March 27, 2018
A V Sobolev1, G V Riabykina, I V Kiseleva
1Russian Cardiology Research Complex, Moscow, Russia.
Insights
Heart rate variability (HRV) dynamics after coronary artery bypass grafting (CABG) were studied using mean weighted rhythmogram variation (MWRV). A decrease in MWRV between 2 and 12 months post-CABG indicates a worse clinical course, necessitating further patient care.
Area of Science:
- Cardiology
- Medical Technology
- Physiology
Context:
- Coronary artery bypass grafting (CABG) is a major surgical procedure for coronary heart disease (CHD).
- Post-CABG recovery and long-term outcomes are critical areas of cardiovascular research.
- Heart rate variability (HRV) is a non-invasive indicator of autonomic nervous system function, reflecting cardiac health.
Purpose:
- To investigate the 24-hour heart rate variability (HRV) dynamics following coronary artery bypass grafting (CABG).
- To establish the relationship between HRV patterns and the clinical course of patients post-CABG.
- To introduce and utilize a novel method, mean weighted rhythmogram variation (MWRV), for HRV assessment.
Summary:
- A study involving 90 patients before CABG and follow-up assessments at 2 weeks, 2, 6, and 12 months post-surgery.
- HRV, measured by MWRV, was consistently lower in CHD patients than healthy individuals.
- Three distinct MWRV dynamic patterns were identified post-CABG, correlating with clinical outcomes: Type 1 (normal) showed no complications, Type 2 indicated adverse events, and Type 3 was associated with various complications.
Impact:
- The study highlights that a significant decrease in MWRV between 2 and 12 months after CABG is linked to poorer clinical outcomes.
- Detection of declining MWRV post-CABG should prompt intensified patient monitoring and care.
- This research provides a valuable prognostic tool for assessing long-term recovery and identifying at-risk patients after CABG.
Aim:
To study dynamics of 24-hour heart rate variability (HRV) after coronary artery bypass grafting (CABG) and to elucidate relationship between HRV dynamics and clinical course of the disease.
Methods And Material:
A novel methodological approach to evaluation of HRV based on measurement of mean weighted rhythmogram variation (MWRV) was implemented. Ninety patients were studied before CABG. Then HRV was assessed in 2 weeks (61 patients), 2 (45 patients), 6 (24 patients)and 12 (33 patients) months after surgery.
Results:
At all study points HRV was lower in CHD patients than in healthy persons. Substantial lowering of average MWRV 2 weeks after surgery was followed by return to preoperative level by the end of 2 months, leveling off until 6 months and some decline by the end of a year. Individual changes of MWRV were assessed in 29 patients in whom HRV was evaluated at 5 or 4 study points. Three types of MWRV changes were distinguished: type 1 - "normal" dynamics (9 patients) - elevation of MWRV 2, 6 and 12 months; type 2 (10 patients) - elevation of MWRV after 2 and 6 months with subsequent lowering by the end of 1 year; type 3 (10 patients) - lowering of MWRV In 2 and/or 6 months. The following relationships between MWRV changes and clinical course after surgery were observed: there were no complications among patients with type 1 MWRV dynamics; 8 of 10 type 2 patients had signs of heart failure, or blood pressure elevation, or recurrence of angina by the end of 1 year: among 10 type 3 patients 6 experienced various complications. Recurrence of angina at various intervals after CABG occurred in 5 patients and in all it was associated with MWRV decrease.
Conclusion:
Pronounced decrease of MWRV between 2 and 12 months after CABG is associated with worse clinical course and its detection should trigger additional investigation and care of a patient.
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