Prognostic value of heart rate variability indexes with regard to acute postinfarction aneurysm of left ventricle formation
DOI:
https://doi.org/10.14739/2310-1210.2017.6.114686Keywords:
myocardial infarction, heart aneurysm, ECG, heart rateAbstract
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
Anikeeva, T. V., & Vorobyov, А. S. (2013) Instrumentalni ta laboratorni mozhlyvosti otsinki strukturno-funktsionalnoho stanu miokarda u patsiientiv z postinfarktnym kardiosklerozom [Instrumental and laboratory possibilities for myocardium structural functional assessment in patients with post infarction cardio sclerosis]. Krovoobih ta hemostaz, 2, 32–36. [in Ukrainian].
Goldovsky, B. M., Yurchak, Yu. V., & Sid, Ye. V (2014) Predyktorna tsinnist analizu variabelnosti sertsevoho rytmu v diahnostytsi fatalnykh arytmii u khvorykh z hostrym infarktom miokarda [Predictive value of heart rate variability analysis in the diagnosis of fatal arrhythmias in patients with acute myocardial infarction]. Medicina neotlozhnyh sostoyanij, 3(58), 109–113. [in Ukrainian].
Zaremba, E. H., Salo, V., Mizak, Y. V., & Zaremba, O. V. (2016) Klinichnii perebih hostroho infarktu miokarda, uskladnenoho hostroiu livoshlunochkovoiu nedostatnistiu pislia koronarnoho obstezhennia zi stentuvenniam [The clinical course of acute myocardial infarction complicated by acute left ventricular failure after coronarographic survey with stenting]. Semejnaya medicina, 3(65), 30–32. [in Ukrainian].
Indyka, S., Yahensky, A., & Dukhnevych, L. (2011) Variabelnist sertsevoho rytmu u khvorykh pislia pislia infarktu miokarda na ambulatornomu etapi reabilitacii [Heart rate variability in patients after myocardial infarction at the outpatient stage of rehabilitation]. Moloda sportyvna nauka Ukrainy, 3, 136–142. [in Ukrainian].
Svitlyk, H. V., Bazylevych, A. Ya., & Harbar, M. O. (2012) Vehetatyvnyi dysbalans pry hostromu infarkti miokarda [Vegetative imbalance at acute myocardial infarction]. Medytsyna transportu Ukrainy, 4, 47–50. [in Ukrainian].
Sirenko, Yu. M. (2014) Medyko-sotsialni problemy kardiolohichnoi dopomohy v Ukraini: shliahy vyrishennia [Medical and social problems of cardiac care in Ukraine: methods of a solution]. Problemy bezperervnoi medychnoi osvity ta nauky, 2, 6–10. [in Ukrainian].
Fedchyshyn, N. Ye. (2013) Analiz likarnianoi letalnosti vid hostroho infarktu miokarda (za danymy Ternopilskoi universytetskoi likarni) [Analysis of hospital lethality from acute myocardial infarction (according to the date of the Ternopil University Hospital)]. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorov’ia Ukrainy, 4(58), 48–51. [in Ukrainian].
Yabluchanskij, N. I., Martynenko, A. V., & Martimyanova, L. A. (2015) Ambulatornaya e´lektrokardiografiya [Ambulatory electrocardiography]. Kharkiv: KhNU im. Karazina. [in Russian].
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
