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Short-Term Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Patients with Coronary Artery
Chang Yan1, Changchun Liu1, Lianke Yao1
1School of Control Science and Engineering, Shandong University, Jinan 250061, China.
Insights
Percutaneous coronary intervention (PCI) may improve autonomic control in coronary artery disease (CAD) patients. Graphical analysis of electrocardiogram (ECG) data showed significant changes in Poincaré plot metrics (Area Index and Porta
Area of Science:
- Cardiology
- Autonomic Neuroscience
- Medical Signal Processing
Background:
- Coronary artery disease (CAD) is linked to autonomic dysfunction, increasing morbidity and mortality risks.
- Percutaneous coronary intervention (PCI) is a common treatment for CAD, but its impact on autonomic control requires systematic evaluation.
Purpose of the Study:
- To investigate the effects of PCI on cardiovascular autonomic function in CAD patients.
- To identify potential electrocardiogram (ECG)-derived metrics for assessing PCI's impact on autonomic control.
Main Methods:
- Pilot study analyzing 5-minute resting ECG signals from 27 CAD patients before and within 24 hours after PCI.
- Quantitative analysis of autonomic function using linear (SDNN, RMSSD, LF, HF, LF/HF) and nonlinear (SampEn, DistEn, CE) methods.
- Assessment using graphical Poincaré plot metrics: Porta's index (PI), Guzik's index (GI), slope index (SI), and area index (AI).
Main Results:
- Significant decreases observed in Area Index (AI) (p < 0.002, Cohen's d = 0.88) and Porta's index (PI) (p < 0.015, Cohen's d = 0.70) after PCI.
- Observed changes in AI and PI were independent of patient sex.
- Effect sizes indicate a moderate to large impact of PCI on these specific autonomic metrics.
Conclusions:
- Graphical metrics AI and PI derived from Poincaré plots of short-term ECG show potential for detecting beneficial effects of PCI on cardiovascular autonomic control.
- These findings suggest that Poincaré plot analysis could serve as a non-invasive tool to monitor treatment response in CAD patients undergoing PCI.
- Further large-scale studies are recommended to validate these promising results and establish clinical utility.
Abstract:
Myocardial ischemia in patients with coronary artery disease (CAD) leads to imbalanced autonomic control that increases the risk of morbidity and mortality. To systematically examine how autonomic function responds to percutaneous coronary intervention (PCI) treatment, we analyzed data of 27 CAD patients who had admitted for PCI in this pilot study. For each patient, five-minute resting electrocardiogram (ECG) signals were collected before and after the PCI procedure. The time intervals between ECG collection and PCI were both within 24 h. To assess autonomic function, normal sinus RR intervals were extracted and were analyzed quantitatively using traditional linear time- and frequency-domain measures [i.e., standard deviation of the normal-normal intervals (SDNN), the root mean square of successive differences (RMSSD), powers of low frequency (LF) and high frequency (HF) components, LF/HF] and nonlinear entropy measures [i.e., sample entropy (SampEn), distribution entropy (DistEn), and conditional entropy (CE)], as well as graphical metrics derived from Poincaré plot [i.e., Porta's index (PI), Guzik's index (GI), slope index (SI) and area index (AI)]. Results showed that after PCI, AI and PI decreased significantly (p < 0.002 and 0.015, respectively) with effect sizes of 0.88 and 0.70 as measured by Cohen's d static. These changes were independent of sex. The results suggest that graphical AI and PI metrics derived from Poincaré plot of short-term ECG may be potential for sensing the beneficial effect of PCI on cardiovascular autonomic control. Further studies with bigger sample sizes are warranted to verify these observations.
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