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Differences in heart rate turbulence between patients with coronary artery disease and patients with ventricular

Alfonso Sestito1, Sergio Valsecchi, Fabio Infusino

  • 1Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy.

The American Journal of Cardiology
|April 28, 2004
PubMed

Insights

Heart rate turbulence (HRT) is impaired in patients with coronary artery disease (CAD), indicating autonomic dysfunction. This impairment is a significant indicator of cardiac autonomic abnormalities in CAD patients.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function

Background:

  • Heart rate turbulence (HRT) reflects physiological changes post-ventricular premature complexes and signifies cardiac autonomic function.
  • Impaired HRT suggests abnormalities in the autonomic control of the heart.

Purpose of the Study:

  • To investigate whether HRT is impaired in patients with stable coronary artery disease (CAD).
  • To compare HRT and heart rate variability (HRV) between CAD patients and those with normal hearts but frequent ventricular arrhythmias.

Main Methods:

  • Analysis of 24-hour Holter recordings for HRT and HRV in 29 CAD patients and 31 normal heart-ventricular arrhythmia (NH-VA) patients.
  • Comparison of HRT variables (turbulence onset, turbulence slope) and HRV parameters between the two groups.

Main Results:

  • Significant differences in HRT variables were observed between CAD patients and NH-VA patients (p < 0.0001).
  • Impaired HRT in CAD patients was independent of myocardial infarction history, left ventricular function, and age.
  • Specific HRT thresholds showed predictive power for discriminating between CAD and NH-VA groups, comparable to some HRV measures.

Conclusions:

  • HRT variables are significantly impaired in patients with CAD compared to those with normal hearts and ventricular arrhythmias.
  • These findings indicate abnormalities in short-term cardiac autonomic control in CAD, characterized by decreased vagal and likely increased sympathetic activity.

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