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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Heart rate variability and turbulence to determine true coronary artery disease in patients with ST segment

Atac Celik1, Ahmet Ozturk, Kerem Ozbek

  • 1Gaziosmanpasa University, Department of Cardiology, Tokat, Turkey. dretaci@yahoo.com

Clinical and Investigative Medicine. Medecine Clinique Et Experimentale
|December 2, 2011
PubMed

Insights

Heart rate variability and turbulence can help identify true coronary artery disease in patients with non-anginal ST depression. These measures aid in distinguishing actual disease from false positive stress tests.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Function
  • Diagnostic Accuracy

Background:

  • ST segment depression without angina on exercise stress tests presents diagnostic challenges, especially in non-diabetic individuals.
  • Heart rate variability (HRV) and heart rate turbulence (HRT) reflect cardiac autonomic function and are often diminished in coronary artery disease (CAD).

Purpose of the Study:

  • To determine specific HRV and HRT parameter values that effectively differentiate true CAD from false-positive exercise stress test results.
  • To identify thresholds for HRV and HRT that predict obstructive coronary artery disease.

Main Methods:

  • Ninety non-diabetic patients with suspected CAD underwent coronary angiography after experiencing ST depression without angina during stress testing.
  • Twenty-four-hour ambulatory ECG recordings were analyzed to calculate HRV and HRT parameters prior to angiography.

Main Results:

  • Patients with obstructive CAD (group 3) showed significantly lower HRV parameters and turbulence slope (TS), and higher turbulence onset (TO) compared to those with normal or non-obstructive coronary arteries (groups 1 and 2).
  • Receiver operating characteristic (ROC) analysis identified diagnostic cut-off values: SDNN ≤ 69.63 msec, TO > 0.14%, and TS ≤ 2.78 msec/RR for predicting obstructive CAD.
  • No significant differences were observed in baseline demographics or clinical characteristics among the groups.

Conclusions:

  • HRV and HRT parameters offer valuable supplementary data for clinical decision-making.
  • These autonomic function measures can assist in discriminating patients who genuinely require coronary angiography from those who do not.
Abstract

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