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Heart Rate Turbulence According to Infarct Localization in ST Elevation MI Patients Who Underwent Primary Percutaneous Coronary Intervention

Year 2020, Volume: 2 Issue: 3, 79 - 85, 29.10.2019

Abstract

Objective: To evaluate heart rate turbulence parameters in ST elevation myocardial
infarction (MI) patients according to localization of infarction and infarct related artery.
Material and

Material and Method: A total of 96 patients who underwent primary percutaneous
coronary intervention were included in this study. They were grouped into two according to
localization of infarction. Patients with atrial fibrillation, prior MI or coronary artery bypass,
only posterior or lateral localization infarct or systemic inflammatory diseases were
excluded. Transthoracic echocardiography was performed and 24- hour holter record was
taken before discharge for all the participants. Heart rate turbulence parameters were
calculated using Schmidt's critearias.

Results: Turbulence slope levels were at normal range in all study population and the
difference was not statistically significant between groups (p= 0.483); turbulence onset
levels were abnormal in 21 patients; 15 of them were in anterior group and it was
significantly lower in inferior infarction group than anteriors (p= 0.005). When circumflex
artery is the infarct related artery in anterior myocardial infarction patients; the difference
was significant and p value was 0.007.

Conclusion: Heart rate turbulence; not turbulence slope but turbulence onset may be a
risk determinator after myocardial infarction at early period and infarct related artery
may play a role in this decision.

References

  • Schmidt G., Malik M., Barthel P., Schneider R.,Ulm K., Rolnitzky L., Camm AJ., Bigger JT., Schomig A. Heart rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lanset. 1999; 353: 1390-96.
  • Lin LY., Lai LP., Lin JL., Du CC., Shau WY., Chan HL., Tseng YZ., Huang SK. Tight mechanism correlation between heart rate turbulence anc baroreflex sensitivity: sequential autonomic blockade analysis. J Cardiovasc Electrophysiol. 2002; 13: 427-31.
  • Francis J., Watanabe MA., Schmidt G. Heart rate turbulence: A new predictor for sudden cardiac death. Ann Noninv Electrocardiol. 2005; 10: 102-09.
  • Ghuran A., Reid F., La Rovere MT., Schmidt G., Bigger JT Jr., Camm AJ., Schwartz PJ., Malik M. ATRAMI investigators. Heart rate turbulence based predictors of fatal and non-fatal cardiac arrest (The Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol. 2002; 89: 184-90.
  • La Rovere MT., Bigger JT Jr., Marcus FI., Montara A., Schwartz PJ. Baroreflex sensitivity and heart rate variability in predictionof total cardiac mortalityafter myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lanset.1998; 351: 478-84.
  • Cygankiewicz I. Heart rate turbulence. Prog Cardiovasc Dis. 2013; 56: 160-71.
  • Watanabe MA., Schmidt G. Heart rate turbulence : a 5-year review. Heart Rhythm. 2004; 6: 732-8.
  • Şahan E., Şahan S. Heart rate turbulence in patients with stable coronary artery disease and its relationship with the severity of the disease. Turk Kardiyol Dern Ars. 2017; 45:106.
  • Disertori M., Mase M., Rigoni M., Nollo G., Ravelli F. Heart rate turbulence is a powerfull predictor of cardiac death and ventricular arrhythmias in post-myocardial infarction and heart failure patients: a systematic review and meta-analysis. Circ Arrhythm Electrophysiol. 2016; 21:566-71.
  • .Pinnacchio G., Lanza GA., Stazi A., Careri G., Coviello I., Mollo R., Crea F. Determinants of heart rate turbulence in individuals without apparent heart disease and in patienst with stable coronary artery disease. Europace 2015; 12: 1855-61.

Primer Perkütan Koroner Girişim Uygulanan ST Elevasyonlu MI Hastalarında Enfarkt Lokalizasyonuna Göre Kalp Hızı Türbülansı Parametrelerinin Değerlendirilmesi

Year 2020, Volume: 2 Issue: 3, 79 - 85, 29.10.2019

Abstract

Amaç: ST elevasyonlu miyokard enfarktüsü (MI) hastalarında kalp hızı türbülansı parametrelerini enfarktüs lokalizasyonuna ve enfarktla ilişkili artere göre değerlendirmek.

Gereç ve Yöntem: Bu çalışmaya primer perkütan koroner girişim uygulanan toplam 96
hasta dahil edildi. Hastalar enfarktüsün lokalizasyonuna göre iki gruba ayrıldı. Atriyal
fibrilasyon, MI veya koroner arter baypass öyküsü olanlar, sadece posterior veya lateral
lokalizasyonlu enfarktüsü veya sistemik enflamatuvar hastalıkları olan hastalar çalışma
dışı bırakıldı. Tüm katılımcılar için transtorasik ekokardiyografi yapıldı ve taburculuktan
önce 24 saat holter kaydı alındı. Kalp hızı türbülansı parametreleri, Schmidt kriterleri
kullanılarak hesaplandı.

Bulgular: Türbülans eğimi düzeyleri tüm çalışma popülasyonunda normal sınırlardaydı ve
gruplar arasında fark istatistiksel olarak anlamlı değildi (p = 0,483). 21 hastada türbülans
başlangıç düzeyleri anormaldi; bunların 15'i anterior miyokard enfarktüsü geçiren
gruptaydı ve inferior miyokard enfarktüs grubunda diğerlerine göre anlamlı olarak daha
düşüktü (p = 0,005). Circumflex arter,anterior miyokard enfarktüslü hastalarda enfarktla
ilişkili arter olduğunda;fark anlamlıydı ve p değeri 0,007 idi.

Sonuç: Kalp hızı türbülansı parametrelerinden türbülans başlangıcı erken dönemde
miyokard enfarktüsü sonrası bir risk belirleyici olabilir ve enfarkt ile ilişkili arter bu kararda
rol oynayabilir.

References

  • Schmidt G., Malik M., Barthel P., Schneider R.,Ulm K., Rolnitzky L., Camm AJ., Bigger JT., Schomig A. Heart rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lanset. 1999; 353: 1390-96.
  • Lin LY., Lai LP., Lin JL., Du CC., Shau WY., Chan HL., Tseng YZ., Huang SK. Tight mechanism correlation between heart rate turbulence anc baroreflex sensitivity: sequential autonomic blockade analysis. J Cardiovasc Electrophysiol. 2002; 13: 427-31.
  • Francis J., Watanabe MA., Schmidt G. Heart rate turbulence: A new predictor for sudden cardiac death. Ann Noninv Electrocardiol. 2005; 10: 102-09.
  • Ghuran A., Reid F., La Rovere MT., Schmidt G., Bigger JT Jr., Camm AJ., Schwartz PJ., Malik M. ATRAMI investigators. Heart rate turbulence based predictors of fatal and non-fatal cardiac arrest (The Autonomic Tone and Reflexes After Myocardial Infarction substudy). Am J Cardiol. 2002; 89: 184-90.
  • La Rovere MT., Bigger JT Jr., Marcus FI., Montara A., Schwartz PJ. Baroreflex sensitivity and heart rate variability in predictionof total cardiac mortalityafter myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lanset.1998; 351: 478-84.
  • Cygankiewicz I. Heart rate turbulence. Prog Cardiovasc Dis. 2013; 56: 160-71.
  • Watanabe MA., Schmidt G. Heart rate turbulence : a 5-year review. Heart Rhythm. 2004; 6: 732-8.
  • Şahan E., Şahan S. Heart rate turbulence in patients with stable coronary artery disease and its relationship with the severity of the disease. Turk Kardiyol Dern Ars. 2017; 45:106.
  • Disertori M., Mase M., Rigoni M., Nollo G., Ravelli F. Heart rate turbulence is a powerfull predictor of cardiac death and ventricular arrhythmias in post-myocardial infarction and heart failure patients: a systematic review and meta-analysis. Circ Arrhythm Electrophysiol. 2016; 21:566-71.
  • .Pinnacchio G., Lanza GA., Stazi A., Careri G., Coviello I., Mollo R., Crea F. Determinants of heart rate turbulence in individuals without apparent heart disease and in patienst with stable coronary artery disease. Europace 2015; 12: 1855-61.
There are 10 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Ozge Ozcan Abacıoglu 0000-0003-1392-9380

Publication Date October 29, 2019
Submission Date June 2, 2020
Acceptance Date October 4, 2020
Published in Issue Year 2020 Volume: 2 Issue: 3

Cite

AMA Ozcan Abacıoglu O. Heart Rate Turbulence According to Infarct Localization in ST Elevation MI Patients Who Underwent Primary Percutaneous Coronary Intervention. Hitit Medical Journal. October 2019;2(3):79-85.