Short-Term Effect of Percutaneous Coronary Intervention on Heart Rate Variability in Patients with Coronary Artery Disease

Abstract

Myocardial ischemia in patients with coronary artery disease (CAD) leads to imbalanced autonomic control that increases the risk of morbidity and mortality. To systematically examine how autonomic function responds to percutaneous coronary intervention (PCI) treatment, we analyzed data of 27 CAD patients who had admitted for PCI in this pilot study. For each patient, five-minute resting electrocardiogram (ECG) signals were collected before and after the PCI procedure. The time intervals between ECG collection and PCI were both within 24 h. To assess autonomic function, normal sinus RR intervals were extracted and were analyzed quantitatively using traditional linear time- and frequency-domain measures [i.e., standard deviation of the normal-normal intervals (SDNN), the root mean square of successive differences (RMSSD), powers of low frequency (LF) and high frequency (HF) components, LF/HF] and nonlinear entropy measures [i.e., sample entropy (SampEn), distribution entropy (DistEn), and conditional entropy (CE)], as well as graphical metrics derived from Poincaré plot [i.e., Porta’s index (PI), Guzik’s index (GI), slope index (SI) and area index (AI)]. Results showed that after PCI, AI and PI decreased significantly (p < 0.002 and 0.015, respectively) with effect sizes of 0.88 and 0.70 as measured by Cohen’s d static. These changes were independent of sex. The results suggest that graphical AI and PI metrics derived from Poincaré plot of short-term ECG may be potential for sensing the beneficial effect of PCI on cardiovascular autonomic control. Further studies with bigger sample sizes are warranted to verify these observations.

Entropy Analysis of Heart Rate Variability in Different Sleep Stages

“…Entropy is a tool to quantify the complexity or irregularity of times series. It has been widely used in analyzing cardiac dynamics [18,39,48,49]. Although some studies have conducted comparisons of entropy indices of RR interval time series in certain sleep stages [24,25], it is not well-studied how they change throughout a whole night's sleep, which may be helpful for sleep staging using ECG signals.…”

Alterations in heart rate variability before and after percutaneous coronary intervention in patients with ischaemic heart disease

“…Coronary artery disease patients tend to have increased sympathetic activity as ischemic event induces this enhanced sympathetic function. [5][6][7][8] Elimination of myocardial ischemia could bring back the autonomic balance state to normal. [6][7][8][9] Only a few studies looked at the role of HRV analyses in the restoration of cardiac autonomic balance in patients with ischaemic heart disease (IHD).…”

“…[5][6][7][8] Elimination of myocardial ischemia could bring back the autonomic balance state to normal. [6][7][8][9] Only a few studies looked at the role of HRV analyses in the restoration of cardiac autonomic balance in patients with ischaemic heart disease (IHD). [5,9] Accordingly, in a study by Gomes et al [5] among stable angina patients, by a combination of methods involving muscle sympathetic nerve activity (MSNA), neurochemical (plasma catecholamine levels) and HRV (time-domain and frequency-domain indices), sympathetic nervous system activity was measured before and 1-month post-percutaneous coronary intervention (PCI).…”