Clinical Application Of Dynamic Electrocardiogram Heart Rate Variability And Heart Rate Variability In Patients With ACS

Objective:In this study,we analyzed the heart rate variability and heart rate deceleration force in patients with acute coronary syndrome by analyzing the dynamic electrocardiogram examinations,and studied in depth the relationship between them and the clinical type,the degree of coronary lesions and the location of diseased vessels,and comprehensive analysis of clinical data,this paper discusses the dynamic electrocardiogram heart rate variability and heart rate deceleration force in patients with acute coronary syndrome in the clinical application value.Methods:Collected on April 1,2021-2022 on March 31 in the Wannan Medical College first affiliated hospital Yijihsan hospital cardiovascular internal medicine,a total of 154 patients with acute coronary syndrome,and a total of 89 cases with negative coronary angiogram results in the same period,the dynamic ecg data collected at the same time the patient and other clinical data.According to the clinical types are divided into acute coronary syndrome(acs),unstable angina,non st segment elevation myocardial infarction st segment elevation myocardial infarction;According to the coronary artery infarction lesions counts are divided into single,double,three;According to the left main coronary artery infarction mainly part points(in),left anterior descending branch(Botswana),left circumflex(LCX),right coronary artery(RCA);According to the records on the results of coronary angiography in patients with ACS Gensini score.According to the Gensini score interquartile range is divided into four groups.The grouping and dynamic electrocardiogram(ecg)data and other clinical data.Results: The data group of 154 ACS patients and 89 controls were statistically analyzed.There were significant differences in smoking and drinking history,troponin,brain natriuretic peptide,white blood cell,C-reactive protein,CK,CK-MB,LDH,TP,ALB,ALT,AST,ALP,Cr,GLU,CHOL,HDL,LDL,LVEF between the two groups(P < 0.05).There were significant differences in SDNN,SDANN,TRI and DC between the two groups(P <0.05).DC risk stratification was significantly different between ACS patients and controls(P < 0.05).The area under the ROC curve was 0.934(P < 0.05),the sensitivity was 0.844,and the specificity was 0.966 for the variables with statistical differences between the ACS group and the control group.DC was positively correlated with SDNN,SDANN,SDNN Index,TRI,TP,VLF,LF and HF.There were significant differences in SDNN,SDANN,SDANN Index,p NN50,TRI,TP,VLF,LF,HF,DC and Gensini scores among STEMI group,NSTEMI group and UA group(P < 0.05).There was significant difference between UA group and STEMI group,NSTEMI group(P < 0.05).The Gensini score was divided into four groups according to the quartile range of 54(33.5,84).There were significant differences in SDNN,SDANN,SDANN Index,TRI,TP,VLF,LF,HF,DC,DC among the four groups(P < 0.05).Among them,the 25% and 75% quantiles had the most significant difference(P < 0.05).The difference of DC in different lesions was statistically significant(P=0.024 < 0.05).The DC in LM group was significantly different from that in LAD,LCX and RCA groups(P < 0.05),but there was no significant difference among LAD,LCX and RCA groups(P > 0.05).Gensini score was negatively correlated with SDNN,SDANN,SDNN Index,p NN50,TRI,TP,VLF,LF,HF and DC.Conclusion:1.HRV and DC indexes are reduced in ACS patients,and the combination of myocardial injury markers and other experimental indexes the highest diagnostic efficacy was achieved.2.The HRV and DC values of ACS patients differed between clinical types,and there was no difference between different lesion branches.Low DC suggests the possibility of LM lesions.3.HRV and DC in ACS patients are significantly negatively correlated with Gensini score,which can be used to evaluate the severity of coronary artery disease.