A Study Of The Diagnostic Value About Coronary Heart Disease And Its Extend By Ambulatory Electrocardiograph And Heart Rate Variability

Objective: To study the predictable value of the diagnosis of coronary heart disease (CHD) and its extend by ambulatory electrocardiograph (AECG) and heart rate variability (HRV).Methods: we selected 126 patients who had undergone 24h AECG and selective coronary angiography (CAG) in the same period. The groups were divided according to the results of CAG. Then we analyzed and compared with all of the data which had accepted by AECG. Results: (1) Significant difference were found in the variables of ST, ST/HR, SDNN, RMSSD, TRI, VLI and Poincare Plot between the groupes of CHD [CAG(+)] and non-CHD [CAG(-)], and the same results were found in the three groups of single, double and triplet coronary pathology. The changes of the variables above were increasing by the extend of coronary pathology. No significant difference were found in the variables of arrhythmia, LH/HF and VAI. (2) Positive correlation was found between the variables of ST, ST/HR and the extend of coronary pathology. While negative correlation was found between the variables of SDNN, TRI, VLI and the extend of coronary pathology. (3) The variables of ST, ST/HR, SDNN had better truthfulness than those of the others in the diagnosis of CHD. The sensitivity to the diagnosis of CHD was increasing by the extend of coronary pathology. The variable of ST/HR had the best diagnostic value in the three variables when we used any single variable. The diagnostic value to CHD would be improved when we combined these variables for use. Compared with all sorts of patterns of connection, parallel connection of ST/HR and SDNN was the best way of connection. (4) Whatever we used single orcombined variables to diagnosis CHD, male was prior to female. Conclusions: (1)ST and ST/HR were the reliable variables of reflecting myocardial ischemia and the extend of coronary pathology. (2) SDNN, TRI and VLI were the sensitive variables of predicting autonomic neuropathy and its extend. (3) Using the method of parralled connection by ST/HR and SDNN could improve the diagnostic value to CHD. (4) Male is prior to female when we used AECG to diagnosis CHD.