Improving Myocardial Perfusion by Percutaneous Coronary Intervention Reduces Central Sympathetic Activity in Stable Angina

Gomes, Marc E.; Aengevaeren, W.R.M.; Lenders, Jacques W.M.; Verheugt, Freek W.A.; Smits, Paul; Tack, Cees J.

doi:10.1002/clc.20676

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…Reduced HRV is associated with decreased cardiac flexibility and resistance to stress, which increase the risks of cardiac events. Previous studies by Gomes et al [3]; Abrootan et al [4]; and Aydinlar et al [5] revealed that restoring myocardial perfusion using percutaneous coronary intervention (PCI) may improve autonomic balance, which is characterized by increased HRV.…”

Section: Introductionmentioning

confidence: 99%

Increased Heart Rate Variability following Elective Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and Preprocedural Anxiety

Oktaramdani

Mudjaddid

Muhadi

et al. 2019

Cardiology Research and Practice

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Background. There is a strong association between chronic ischemia and autonomic imbalance. Percutaneous coronary intervention (PCI) may restore autonomic balance in patients with stable coronary artery disease (SCAD), which is characterized by increased heart rate variability (HRV). Anxiety is often found in patients who are going to undergo invasive procedures and has been identified to induce autonomic imbalance. The aim of our study is to identify the impact of preprocedural anxiety on increased HRV following an elective PCI. Methods. Our study was a pretest and post-test correlation study involving 44 SCAD patients who underwent elective PCI at Cipto Mangunkusumo National Hospital. The HRV was measured before and after PCI. Anxiety symptoms were evaluated using Hospital Anxiety Depression Score (HADS) questionnaires. Results. We found a higher increase on HRV parameter following the PCI of subjects in the nonanxiety group compared with the anxiety group (median = 9.11 vs. 2.83; U = 154.00; p=0.043). Conclusions. Preprocedural anxiety may inhibit HRV increase following PCI procedure.

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Section: Introductionmentioning

confidence: 99%

Increased Heart Rate Variability following Elective Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and Preprocedural Anxiety

Oktaramdani

Mudjaddid

Muhadi

et al. 2019

Cardiology Research and Practice

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“…The calculated sample size of 24 patients for the primary endpoint was missed by 6 subjects (n = 18), as we overestimated the rate of successful MSNA registrations. The per visit success rate of MSNA recordings is reported as 70% in literature [ 45 ]. We had a 56% success rate on visit 1.…”

Section: Discussionmentioning

confidence: 99%

Inhaled β-agonist does not modify sympathetic activity in patients with COPD

et al. 2015

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BackgroundNeurohumoral activation is present in COPD and might provide a link between pulmonary and systemic effects, especially cardiovascular disease. Because long acting inhaled β-agonists reduce hyperinflation, they could reduce sympathoexcitation by improving the inflation reflex. We aimed to evaluate if inhaled therapy with salmeterol reduces muscle sympathetic nerve activity (MSNA) evaluated by microneurography.MethodsMSNA, heart rate, blood pressure, and respiration were continually measured. After baseline recording of 20 minutes, placebo was administered; after further 45 minutes salmeterol (50 μg) was administered which was followed by a further 45 minutes of data recording. Additionally, lung function, plasma catecholamine levels, arterial pulse wave velocity, heart rate variability, and baroreflex sensitivity were evaluated. Following 4 weeks of treatment with salmeterol 50 μg twice daily, measurements were repeated without placebo administration.ResultsA total of 32 COPD patients were included. Valid MSNA signals were obtained from 18 patients. Change in MSNA (bursts/100 heart beats) following acute administration of salmeterol did not differ significantly from the change following placebo (-1.96 ± 9.81 vs. -0.65 ± 9.07; p = 0.51) although hyperinflation was significantly reduced. Likewise, no changes in MSNA or catecholamines were observed after 4 weeks. Heart rate increased significantly by 3.8 ± 4.2 (p < 0.01) acutely and 3.9 ± 4.3 bpm (p < 0.01) after 4 weeks. Salmeterol treatment was safe and well tolerated.ConclusionsBy using microneurography as a gold standard to evaluate sympathetic activity we found no change in MSNA following salmeterol inhalation. Thus, despite an attenuation of hyperinflation, the long acting β-agonist salmeterol does not appear to reduce nor incite sympathoexcitation.Trial registrationThis study was registered with the European Clinical Trials Database (EudraCT No. 2011-001581-18) and ClinicalTrials.gov (NCT01536587).Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0054-7) contains supplementary material, which is available to authorized users.

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“…In these patients, imbalance in the autonomic regulation may occur because of chronic ischemia and hypoxia 6,7 . Some studies in the past observed a decrease in heart rate variability (HRV) indices in these patients, whereas others have reported that patients with CSA often have augmented sympathetic influence 8,9 . The chronic state of ischemic myocardium appears to be the reason for this autonomic dysfunction.…”

Section: Introductionmentioning

confidence: 99%

A Study of Cardiac Autonomic Functions in Patients with Chronic Stable Angina Undergoing Percutaneous Coronary Revascularization

Alauddin¹,

Chaswal²,

Bashir³

et al. 2021

MMJ

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Objective: In the present study, cardiac autonomic functions in CSA patients were evaluated before and after percutaneous coronary intervention (PCI) using heart rate variability (HRV). Methods: Thirty patients with CSA were recruited from cardiology outpatient clinics of VMMC and Safdarjung hospital, New Delhi, India. For each patient HRV parameters (LF, HF, LF: HF ratio, SDNN, RMSSD, total power, and pNN50) were gathered before and after PCI. Data were compiled and analyzed using licensed statistical software: SPSS version 21.0. Results: Out of 30 subjects, SDNN (61.47±22.27 vs. 32.24±16.50ms, p<0.0001), RMSSD (53.86±31.41 vs. 28.81±23.80ms, p=0.001) and pNN50 (46.24±34.36 vs. 5.20±6.63, p<0.0001) in post-PCI were significantly higher as compared to the pre-PCI values. There were significant increases in both LF (1193ms2±302.04ms2vs. 1054.60ms2±208 ms2, p<0.001) and HF (991.57±872.40ms2vs. 466.72ms2±257.93ms2, p<0.0001), also in total power (3548.37ms2±807.73ms2vs. 2428 ms2±867.07 ms2, p<0.0001) in post-PCI as compared to pre-PCI. The LF: HF ratio in pre-PCI was higher as compared to post-PCI (1.467±1.639 vs. 1.143±0.852, p=0.805), but the difference was not statistically significant. Conclusion: In this preliminary study, it is concluded that there is significant improvement in resting cardiovascular parameters, resting autonomic tone as measured by HRV which shows increase in both parasympathetic as well as sympathetic reactivity following revascularization by PCI in CSA patients. Hence, we also suggest that the use of noninvasive tests such as HRV should be done to stratify further risk of disease progression.

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Improving Myocardial Perfusion by Percutaneous Coronary Intervention Reduces Central Sympathetic Activity in Stable Angina

Cited by 15 publications

References 19 publications

Increased Heart Rate Variability following Elective Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and Preprocedural Anxiety

Increased Heart Rate Variability following Elective Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and Preprocedural Anxiety

Inhaled β-agonist does not modify sympathetic activity in patients with COPD

A Study of Cardiac Autonomic Functions in Patients with Chronic Stable Angina Undergoing Percutaneous Coronary Revascularization

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