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Effects of coronary revascularization by elective percutaneous coronary intervention on cardiac autonomic modulation
Mahmoud Abdelnabi1, Moataz Zaki1, Mohamed Sadaka2
1Cardiology and Angiology Unit, Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria University Alexandria, Egypt.
Insights
Percutaneous coronary intervention (PCI) improves autonomic function in coronary artery disease (CAD) patients, as measured by heart rate variability (HRV). Complete revascularization leads to better autonomic modulation post-PCI.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Medical Device Technology
Background:
- Coronary artery disease (CAD) is associated with impaired autonomic modulation.
- Heart rate variability (HRV) is a key indicator of autonomic function.
- Percutaneous coronary intervention (PCI) is a common revascularization strategy for CAD.
Purpose of the Study:
- To evaluate the impact of elective PCI on autonomic modulation in CAD patients.
- To assess changes in HRV parameters before and after PCI.
- To compare HRV outcomes between complete and incomplete revascularization.
Main Methods:
- A prospective cohort study of 100 CAD patients undergoing elective PCI.
- HRV was measured using a handheld device (CheckMyheart™) at baseline, 24 hours, and 6 months post-PCI.
- Time and frequency domain HRV parameters were analyzed, alongside SYNTAX and residual SYNTAX scores.
Main Results:
- PCI significantly improved HRV time and frequency domain parameters (p<0.001).
- Statistically significant differences in HRV were observed between complete revascularization (CR) and incomplete revascularization (IR) groups at 24 hours and 6 months post-PCI (p<0.001).
Conclusions:
- Coronary revascularization via PCI enhances autonomic modulation in CAD patients, as evidenced by HRV.
- Complete revascularization is associated with superior autonomic modulation compared to incomplete revascularization post-PCI.
Objective:
To study the effects of coronary revascularization using elective percutaneous coronary intervention (PCI) on autonomic modulation assessed by heart rate variability measurement (HRV) in coronary artery disease (CAD) patients.
Methods:
A single-center prospective cohort study included 100 patients were included undergoing elective PCI excluding those with contraindication to contrast or dual antiplatelet therapy, atrial fibrillation or multiple premature beats, receiving anti-arrhythmic drugs and those who underwent previous PCI or coronary artery bypass graft (CABG). Short-term measurement of time domain parameters (mean, SDNN, RMSSD) and frequency domain parameters (LF component, HF component, LF/HF ratio) of HRV was performed at the same time of the day, pre-PCI, 24 hours and 6 months post-PCI by CheckMyheart™ handheld HRV device. 5-min HRV analysis software was used to interpret the data using standard methods of HRV measurement of the Task Force of The European Society of Cardiology (ESC) and The North American Society of Pacing and Electrophysiology. SYNTAX (SX) score was calculated before PCI and residual SYNTAX (rSS) score was calculated after PCI using SYNTAX score calculator software.
Results:
The mean age of the studied population was 56.89±10.75 years with 85% males. HRV time and frequency domain parameters showed a statistically significant improvement at different time intervals (before PCI, 24 hours and 6 months after PCI) (p-value <0.001). HRV time and frequency domain measures showed a statistically significant difference between time and frequency domain HRV parameters 24 hours and 6 months after PCI in patients who had complete revascularization (CR) with those who had incomplete revascularization (IR). (p-value <0.001).
Conclusion:
Autonomic modulation in CAD patients was improved by coronary revascularization using PCI assessed by serial HRV measurement. Patients with CR had better autonomic modulation than those with IR assessed by HRV 24 and 6 months after PCI.
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