Koroner arter hastalığında risk faktörleri ve koroner arter lezyonu yaygınlığının kalp atım hızı değişkenliği üzerine etkileri

Abstract

ÖZET Koroner Arter Hastalığında Risk Faktörleri Ve Koroner Arter Lezyonu Yaygınlığının Kalp Atım Hızı Değişkenliği Üzerine Etkileri Koroner arter hastalığında vagal aktivitede azalma sık olarak görülmektedir. Koroner arter hastalığındaki kalp atım hızı değişkenliği (HRV) azalmasından hangi faktörlerin sorumlu olduğu tam bilinmemektedir. Bundan dolayı, bu çalışmadaki amacımız, koroner arter hastalığı olan hastalardaki risk faktörleri, koroner arter lezyon yaygınlığı ve şiddeti ile HRV arasındaki ilişkiyi incelemekti. Koroner anjiografi yapılan 186 hasta çalışmaya alındı. HRV analizi frekans domain analizi (Fourier transformasyon) kullanılarak çok düşük, düşük, yüksek ve çok yüksek frekans bileşenlerin güçleri ve total güç hesaplandı. Üç-damar hastalarında HRV'nin parasempatik bileşeni 1 -damar hastalara ve normal bireylere göre daha düşük bulundu (PO.05). Koroner arter lezyonunun yaygınlığı, RR aralığı ve yaş ile HRV indeksleri arasında korelasyon bulundu (P<0.05). Koroner arter hastalığı olan hastalarda miyokard infarktüsü (Mİ) (anterior ve inferior) ve diabetes mellitus varlığı HRV'yi azaltmaktadır. Sonuç olarak, koroner arter hastalarındaki HRV düşüklüğü ile koroner arter lezyonunun yaygınlığı ve şiddeti arasında ilişki mevcuttur. Koroner arter hastalığında Mİ, diabetes mellitus ve taşikardi varlığı ve yaşlılık HRV'nin bozulmasına sebep olan önemli faktörlerdir. Anahtar Kelimeler: Kalp atım hızı değişkenliği, koroner arter hastalığı, risk faktörleri, koroner anjiografi VllABSTRACT Effects of Risk Factors and Extents of Coronary Artery Lesion on Heart Rate Variability in Coronary Artery Disease Decreased vagal activity is frequently observed in coronary artery disease (CAD). It is still not well known which factors are responsible for decreased heart rate variability (HRV) in CAD. That is why, the aim of this study was to assess the relationship between HRV and extent and severity of coronary artery lesions and risk factors in patients with CAD. One hundred and eighty six patients who underwent coronary angiography were assigned to the study. HRV analysis was accomplished using frequency domain analysis (Fourier transformation). We assessed the powers of very low, low, high and very high frequency band and total power. Parasympathetic component of HRV was decreased in patients with multivessels CAD as compared with normal subjects and single vessel disease (PO.05). HRV was closely related with severity and extent of CAD, RR interval and age (P<0.05). History of myocardial infarction (MI) (anterior or inferior) and concomitant diabetes mellitus were two important factors modify HRV in patients with CAD. In conclusion, HRV is reduced in CAD being closely related to severity and extent of coronary artery lesion. Presence of MI, diabetes mellitus, tachycardia and ageing are important factors cause impairment of HRV in CAD. Key Words : heart rate variability, coronary artery disease, risk factors, coronary angiography VUl

ABSTRACT Effects of Risk Factors and Extents of Coronary Artery Lesion on Heart Rate Variability in Coronary Artery Disease Decreased vagal activity is frequently observed in coronary artery disease (CAD). It is still not well known which factors are responsible for decreased heart rate variability (HRV) in CAD. That is why, the aim of this study was to assess the relationship between HRV and extent and severity of coronary artery lesions and risk factors in patients with CAD. One hundred and eighty six patients who underwent coronary angiography were assigned to the study. HRV analysis was accomplished using frequency domain analysis (Fourier transformation). We assessed the powers of very low, low, high and very high frequency band and total power. Parasympathetic component of HRV was decreased in patients with multivessels CAD as compared with normal subjects and single vessel disease (PO.05). HRV was closely related with severity and extent of CAD, RR interval and age (P<0.05). History of myocardial infarction (MI) (anterior or inferior) and concomitant diabetes mellitus were two important factors modify HRV in patients with CAD. In conclusion, HRV is reduced in CAD being closely related to severity and extent of coronary artery lesion. Presence of MI, diabetes mellitus, tachycardia and ageing are important factors cause impairment of HRV in CAD. Key Words : heart rate variability, coronary artery disease, risk factors, coronary angiography VUl