Evaluating The Significance Of Heart Rate Variability In The Old Patients With Coronary Heart Disease

Objective: Exploring the characteristics of the heart rate variability of the old patients with coronary heart disease, evaluating the condition of autonomic nerve function, guiding the treatment of coronary heart disease, predicting the condition and prognosis.Background: Cardiovascular disease is a very common disease, which is harmful to human,s health. It is the enemy of China and all the world. With the economic developed and the living standards improved, the problem of population aging is becoming more and more obviously, the morbidity is gradually increasing, and coronary heart disease(CHD) is rapidly rising to the top of cardiovascular disease, coronary heart disease of the old patients has attracted more attention. Therefore, improving the level of the treatment and prevention is essential, especially for the coronary heart disease. As we all know, coronary angiography(CAG) is the gold standard for recognized diagnosis of coronary heart disease in particular, especially for the coronary artery stenosis. But its invasive nature and high cost means it is hard to spread in China. Dynamic electrocardiogram is a practical, non-invasive, safe, reproducible detection technology. The targets of the dynamic electrocardiogram can be detected more and more, especially the indexes of heart rate variability(HRV). It has clinical value for guiding the diagnosis and treatment of coronary heart disease, evaluating the condition of autonomic nerve damage, determine the condition and prognosis. Methods: Select 92 cases on the First Clinical Hospital of Jilin University medical wards of the hospital from January 2008 to March 2010, including 62 cases which have been diagnosed coronary heart disease according to the diagnostic criteria of WHO, 60-85 years old, 36 cases are male, 26 cases are female, all of them are in sinus rhythm, cardiac function (NYHA criteria)â… orâ…¡level, and all the cases except for diseases affecting heart rate variability, for example, acute myocardial infarction, atrioventricular and bundle branch block, sick sinus syndrome, hyperthyroidism, diabetes, chronic obstructive pulmonary disease and so on. All the participants did not take the drugs one week before they accept DCG, which maybe affect the cardiovascular autonomic nerve function. Then dividing A group into ventricular arrhythmias group(A1 group) 32 cases and myocardial ischemia group(A2 group) 30 cases, otherwise, normal group(B group) 30 cases, 60-82 years old, 19 cases are male, 11 cases are female, which have accept physical examination and the results have been confirmed without coronary heart disease. According to the results of the DCG of the 92 cases, analysis of the characteristics of HRV for each group and the HRV time domain indexes, evaluating the significance of heart rate variability in the old patients with coronary heart disease.Results: The HRV indexes of CHD ventricular arrhythmias group are lower than the normal group, SDNN and SDANN have significant difference. The HRV indexes of CHD myocardial ischemia group is lower than the normal group, they do not have significant difference.Conclusion:1. The HRV indexes is low in the old patients with coronary heart disease, the autonomic nerve function was damaged.2. The HRV time domain indexes SDNN, SDANN are the sensitive indicator, which evaluate the autonomic nerve dysfunction and severity with coronary heart disease . 3. The HRV indexes have extremely valuable in evaluating the coronary heart disease and ventricular arrhythmias. HRV indexes can be used as a noninvasive predictor for the old patients with coronary heart disease.