Impaired autonomic function after incomplete revascularisation

Area of Science:

• Cardiology
• Autonomic Nervous System Function
• Cardiovascular Physiology

Background:

• Incomplete cardiac revascularisation (ICR), indicated by a high residual SYNTAX score (rSs), is associated with increased 5-year mortality.
• Impaired autonomic function, assessed by heart rate recovery time (HRR10-20) after an active stand, is linked to higher all-cause mortality in the general population.

Purpose of the Study:

• To investigate the hypothesis that ICR is associated with impaired autonomic function, specifically measured by HRR10-20.

Main Methods:

• Consecutive patients undergoing percutaneous coronary revascularisation were enrolled after informed consent.
• Heart rate, blood pressure, and ECG were recorded during an active stand to determine HRR10-20.
• Patients were categorized into complete revascularisation (CR, rSs=0) and ICR (rSs>0) groups.

Main Results:

• A total of 53 patients (37 CR, 16 ICR) were analyzed. The mean rSs in the ICR group was 9.4.
• HRR10-20 was significantly impaired in the ICR group (-3±0.60) compared to the CR group (-6.56±0.52) (p<0.0001).
• A strong correlation (Pearson's r=0.529, p<0.0001) was found between completeness of revascularisation and HRR10-20.

Conclusions:

• The study confirms a significant correlation between ICR and impaired autonomic function, as indicated by heart rate recovery speed.
• Assessing autonomic dysfunction in patients with ICR may serve as a valuable tool for identifying individuals at increased risk of mortality.