Assessment of cardiac autonomic functions by heart rate recovery indices in patients with myocardial bridge

Okutucu, Sercan; Aparcı, Mustafa; Şabanoğlu, Cengiz; Karakulak, Uğur Nadir; Aksoy, Hakan; Öztürk, Cengiz; Karaduman, Mehmet; Işılak, Zafer; Adar, Adem; Oto, Ali̇

doi:10.5603/cj.a2016.0046

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…6,7 The decline in HR during recovery is principally due to a reactivation of the parasympathetic nervous system, mostly in the early recovery period. 8,9 Inadequate decline in HR immediately after exercise, reflects reduced parasympathetic nervous system activity and this is defined as an attenuated HRR. 10,11 Kannankeril et al 12 demonstrated that sympathetic withdrawal also contributes significantly to early HRR.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Fatihoğlu¹,

Kaya²,

Koçyiğit³

et al. 2022

Eur J Ther

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Objective: Although the introduction of radiation therapy for the management of thoracic malignancies has led to a significant improvement in disease-specific survival, this has resulted in the emergence of a new spectrum of cardiovascular disorders induced by radiation injury. Heart rate recovery, as a predictor of cardiovascular events and an indicator of autonomic functions, is measured non-invasively and easily. In the present study, we investigated the effects of mediastinal radiotherapy on heart rate recovery parameters. Methods: Twenty-one patients were included in this study who were planned to receive chest radiotherapy because of lymphoma or lung cancer. Heart rate recovery parameters were evaluated by treadmill exercise before and after radiotherapy. Results: We have found decrease in heart rate recovery parameters (26.05 ± 12.54 vs. 19.52 ± 12.28 for HRR1, 39.1 ± 16.15 vs. 32.86 ± 14.83 for HRR2, 42.81 ± 17.66 vs. 38.05 ± 16.14 for HRR3). The higher doses of mediastinal radiotherapy caused significant changes on heart rate recovery parameters. HRR1 changed from 25.70 ± 15.12 to 22.00 ± 14.38 in low dose group and from 26.36 ± 10.41 to 17.27 ± 10.10 in high-dose group (P < .05). Attenuation of HRR2 and HRR3 were also more evident in high mediastinal dose group (P < .05). Conclusion: Heart rate recovery parameters were decreased especially in patients who were exposed to more intense mediastinal radiation.

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Section: Discussionmentioning

confidence: 99%

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Fatihoğlu¹,

Kaya²,

Koçyiğit³

et al. 2022

Eur J Ther

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“…However, the optimal ap-proach to assess MB by coronary angiography as well as by FFR remains unclear, due to the cyclic dynamic stenosis of MB [16]. Therefore, MB of- ten causes clinical dilemmas, which widely raise concerns [17].…”

Section: Discussionmentioning

confidence: 99%

Quantitative flow ratio-guided surgical intervention in symptomatic myocardial bridging

Liu

Yuan

et al. 2020

Cardiol J.

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Background: Patients with myocardial bridging (MB) are associated with adverse cardiovascular events, but a decision to perform surgical intervention, especially for patients with systolic intermediate stenosis, is a difficult clinical issue. Fractional flow reserve (FFR) represents a novel method for the functional evaluation of coronary stenosis, but the relationship between FFR and MB remains controversial because of the cyclic dynamic stenosis of MB. Quantitative flow ratio (QFR) is a novel index allowing fast assessment of FFR from a diagnostic coronary angiography. This study aimed to investigate the relationship between QFR and MB patients and to further develop a prediction model of QFR-guided surgical intervention for these patients. Methods: Forty-five symptomatic lone MB patients who had undergone coronary angiography were consecutively enrolled in this study. MB was located in the middle of left anterior descending artery with intermediate stenosis during systole. The patients were retrospectively divided into a medical therapy group or a surgical therapy group. Systolic geometry based QFR (SG-QFR) and diastolic geometry based QFR (DG-QFR) were calculated based on three-dimensional quantitative coronary angiography and patient-specific flow velocity. Subsequently, time-averaged QFR (TA-QFR) is defined as the average of SG-QFR and DG-QFR. Results: Receiver operating characteristic curve analysis revealed that TA-QFR (AUC = 0.91; 95% CI: 0.79-0.98

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“…proved that fractional flow reserve (FFR) to dobutamine challenge is significantly decreased in the presence of microvascular endothelial dysfunction 65 . Heart rate recovery is a prognostic tool for the cardiac autonomic functions 68 ; increased heart rate recovery (HHR) was associated with decreased parasympathetic activity 69 , a higher susceptibility for atherosclerosis, and increased five-year mortality 70 . Okutucu showed the presence of MB on LAD to be a significant predictor for increased HHR at 1 minute (b = −8.524; 95% CI −14.934 to −2.113; p = 0.009), and argued that the finding was caused by silent or symptomatic myocardial ischemia.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression

Hostiuc

Rusu

Hostiuc

et al. 2017

Sci Rep

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Myocardial bridging, a congenital abnormality in which a coronary artery tunnels through the myocardial fibres was usually considered a benign condition. Many studies suggested a potential hemodynamic significance of myocardial bridging and some, usually case reports, implied a possible correlation between it and various cardiovascular pathologies like acute myocardial infarction, ventricular rupture, life-threatening arrhythmias, hypertrophic cardiomyopathy, apical ballooning syndrome or sudden death. The main objective of this article is to evaluate whether myocardial bridging may be associated with significant cardiac effects or if it is strictly a benign anatomical variation. To this purpose, we performed a meta-analysis (performed using the inverse variance heterogeneity model) and meta-regression, on scientific articles selected from three main databases (Scopus, Web of Science, Pubmed). The study included 21 articles. MB was associated with major adverse cardiac events - OR = 1.52 (1.01–2.30), and myocardial ischemia OR = 3.00 (1.02–8.82) but not with acute myocardial infarction, cardiovascular death, ischemia identified using imaging techniques, or positive exercise stress testing. Overall, myocardial bridging may have significant cardiovascular consequences (MACE, myocardial ischemia). More studies are needed to reveal/refute a clear association with MI, sudden death or other cardiovascular pathologies.

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Assessment of cardiac autonomic functions by heart rate recovery indices in patients with myocardial bridge

Abstract: Background: Heart rate (HR) recovery (HRR) reflects autonomic activity and predicts cardiovascular events. The aim of this study was to assess HRR in patients with myocardial bridge (MB p = 0.009 (Cardiol J 2016; 23, 5: 524-531)

Cited by 5 publications

References 22 publications

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Assessment of Cardiac Autonomic Functions by Heart Rate Recovery Indices in Patients Receiving Chest Radiotherapy

Quantitative flow ratio-guided surgical intervention in symptomatic myocardial bridging

Cardiovascular consequences of myocardial bridging: A meta-analysis and meta-regression

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