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Effect of coronary arterial occlusion on vagal control of heart rate
K E Airaksinen1, M J Niemelä, M J Ikäheimo
1Department of Medicine, Oulu University Central Hospital, Finland.
Insights
Short coronary artery occlusion during angioplasty temporarily impairs vagal control of heart rate in patients with coronary artery disease, indicated by reduced heart rate variation.
Area of Science:
- Cardiology
- Autonomic Nervous System Function
Background:
- Diminished heart rate variation often signifies impaired vagal control in coronary artery disease.
- Assessing autonomic function during acute cardiac events is crucial.
Purpose of the Study:
- To evaluate the impact of short-term myocardial ischemia induced by coronary arterial occlusion on heart rate variation.
- To determine if acute ischemia affects vagal control during percutaneous transluminal coronary angioplasty.
Main Methods:
- Measured heart rate variation during controlled deep breathing in 50 patients.
- Compared measurements before and during coronary arterial occlusion in therapeutic percutaneous transluminal coronary angioplasty.
- Monitored heart rate, blood pressure, and catecholamine levels.
Main Results:
- Heart rate variation significantly decreased from 11.1 ± 4.5 to 9.5 ± 5.1 beats/min during arterial occlusion (P < 0.01).
- No significant changes were observed in heart rate, blood pressure, noradrenaline, or adrenaline levels.
- The reduction in heart rate variation was not linked to occlusion site, duration, or chest pain.
Conclusions:
- Brief coronary arterial occlusion during angioplasty impairs vagal control of heart rate.
- This impairment is measurable via heart rate variation during deep breathing.
- Findings highlight the sensitivity of autonomic control to acute ischemic events in coronary artery disease patients.
Abstract:
Diminished variation in heart rate as a sign of impaired vagal control is common in coronary arterial disease. To evaluate the effect of short-term myocardial ischaemia induced by coronary arterial occlusion during therapeutic percutaneous transluminal coronary angioplasty we measured the variation in heart rate during controlled deep breathing in 50 patients before and during arterial occlusion. Variation in heart rate diminished from 11.1 +/- 4.5 to 9.5 +/- 5.1 beats/min (P less than 0.01) during occlusion. No change occurred in heart rate, blood pressure or levels of noradrenaline and adrenaline. The attenuation of variation in the heart rate was not significantly associated with the site or duration of arterial occlusion nor concomitant chest pain. Thus, brief coronary arterial occlusion seems to be associated with impairment of the vagal control of heart rate in patients with coronary arterial disease.