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. 2021 Feb 15;11(1):164-175.
eCollection 2021.

Effects of coronary revascularization by elective percutaneous coronary intervention on cardiac autonomic modulation assessed by heart rate variability: a single-center prospective cohort study

Mahmoud Abdelnabi  1 , Moataz Zaki  1 , Mohamed Sadaka  2 , Moustafa Nawar  2
Affiliations

Effects of coronary revascularization by elective percutaneous coronary intervention on cardiac autonomic modulation assessed by heart rate variability: a single-center prospective cohort study

Mahmoud Abdelnabi et al. Am J Cardiovasc Dis. .

Abstract

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.

Keywords: Coronary artery disease; autonomic modulation; complete revascularization; coronary revascularization; heart rate variability; major adverse cardiovascular and cerebrovascular events; percutaneous coronary intervention; residual syntax score; syntax score.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Correlation between HRV parameters at different time intervals before, showing a significant improvement 24 hours and 6 months after PCI.
Figure 2
Figure 2
Relation between different HRV parameters and rSS 24 hours after PCI.
Figure 3
Figure 3
Relation between different HRV parameters and rSS 6 months after PCI.
Figure 4
Figure 4
Comparison between HRV time and Frequency domain before and 24 hours after PCI in patients who had MACCE.
See this image and copyright information in PMC

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