Prognostic value of heart rate variability indexes with regard to acute postinfarction aneurysm of left ventricle formation

Authors

  • S. M. Kyselov Zaporizhzhia State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2017.6.114686

Keywords:

myocardial infarction, heart aneurysm, ECG, heart rate

Abstract

Prediction of Q-wave myocardial infarction complications in acute period is an actual problem of modern cardiology.

Aim: to determine the prognostic value of heart rate variability indices with regard to acute left ventricular aneurysm development in patients with Q-wave myocardial infarction.

Materials and мethods: time and spectral parameters of heart rate variability, number of arrhythmias and ischemia were investigated by daily monitoring of electrocardiogram in 238 patients with acute Q-wave myocardial infarction. ROC analysis with the characteristic curve construction was used to determine prognostically significant parameters. Predictive significance of indicators with regard to left ventricular aneurysms formation was assessed at a relative risk with a confidence interval of 95 %. Stepwise multivariate regression analysis of Cox proportional hazards to independent predictors of acute post-infarction left ventricular aneurysm formation determination was used.

Results. In patients with Q-wave myocardial infarction and aneurysm of left ventricle it has been shown a reduction in time parameters of heart rate variability, the sympathetic-parasympathetic balance shift towards the sympathetic component activation and parasympathetic influence decreasing, increasing number of ventricular arrhythmias by means of life-threatening arrhythmias, and longer duration of corrected QT interval. The analysis of associations has made it possible to establish a close relationship between left ventricular aneurysm formation and parameters of electrocardiogram daily monitoring. With the help of ROC analysis we identified prognostically significant indicators of electrocardiogram daily monitoring with regard to acute postinfarction left ventricular aneurysm formation. Analysis of Cox proportional hazards has allowed the establishing of left ventricle aneurysm formation independent predictors.

Conclusions. It has been revealed an increase in sympathetic autonomic nervous system influence, prevalence of life-threatening ventricular arrhythmia episodes and corrected QT interval duration in patients with acute Q-wave myocardial infarction and left ventricular aneurysm. The main indicators of heart rate variability and arrhythmias have a close connection with early postinfarction left ventricular aneurysm formation. Duration of the corrected QT interval is an independent predictor of acute postinfarction left ventricle aneurysm formation.

References

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How to Cite

1.
Kyselov SM. Prognostic value of heart rate variability indexes with regard to acute postinfarction aneurysm of left ventricle formation. Zaporozhye medical journal [Internet]. 2017Nov.15 [cited 2024Apr.20];(6). Available from: http://zmj.zsmu.edu.ua/article/view/114686

Issue

No. 6 (2017)

Section

Original research

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