Study On Heart Rate Variability In Patients With Qi-Yin Deficiency Syndrome Of Coronary Artery Disease And Diabetes Mellitus

Background The autonomic nervous system (ANS) plays an important role not only in physiological situations, but also in various pathological settings such as diabetic mellitus(DM) and myocardial infarction (MI). Autonomic imbalance has been strongly implicated in the path physiology of arrhythmogenesis and sudden cardiac death. Heart rate variability (HRV) has emerged as a simple, noninvasive method to evaluate the ANS (sympatho-vagal) balance. It is suggested that the traditional chinese medicine (TCM) syndrome is the reaction of the whole body at some stage of the disease, and reflects the pathological elements, such as the reason, the quality, the range and the trend of the particular disease. Qi-Yin deficiency syndrome is very common in the pathological process of coronary artery disease(CAD) and DM patients. Objective In this writing, attempts are made to investigate characteristics of HRV in patients with CAD and DM. Second, to definite whether Qi-Yin deficiency syndrome of CAD and DM have the similar autonomic nerve state. Methods 120 patients with Qi-Yin deficiency syndrome(60 CAD and 60 DM)and 60 healthy controls were included. Time domain analysis, frequency domain analysis and nonlinear analysis were used to the characteristics of HRV. The time domain indexes of HRV include standard diviation of NN intervals(SDNN), standard diviation of average 5 min NN intervals(SDANN), root mean square of standard diaviation of NN intervals(RMSSD), percent of the number whose difference between adjacent NN interval are more than 50 ms(PNN50) and HRV index. The frequency domain analysis indices include total power(TP), the very low frequency band (VLF), the low frequency band (LF) and the high frequency band (HF).Three quantity indices includes the area of plot (SQ), long-axis (LA) and short axis (SA)of Lorenz dot plot were used. Nonlinear analysis of HRV indexes include complexity (comp), Approximate Entropy (ApEn) and correlation dimension (cordm).Results 1 The time domain indexes(SDNN, SDANN, RMSSD, HRVindex) and frequency domain indices(TP, VLF, LF, HF) of HRV in patients with Qi-Yin deficiency syndrome were significantly lower than that in the healthy controls (P< 0.01).The indices of Lorenz dot plot(SQ, LA,SA) and nonlinear analysis(comp, ApEn, cordm) in patients with Qi-Yin deficiency syndrome showed markedly decreased compared with normal patients. The non-linear indices in healthy control had obvious day-to-night change, while the change in patients with Qi-Yin deficiency syndrome was deceased.2 There was no differences of Lorenz dot plot(SQ, LA,SA)between CAD patients and DM patients. The time domain indexes RMSSD, frequency domain indices HF, non-linear indices ApEn and cordm were in DM patients were lower than CAD patients (P< 0.01). But the non-linear indices comp were in DM patients were higher than CAD patients (P < 0.01). Conclusion The autonomic nervous system were injured in patients with Qi-Yin deficiency syndrome, and some HRV indexes can be used for the reference of TCM syndrome differentiation. The vegetal never system were injured in patients with DM and more serious turbulence than that in CAD patients. Based on the TCM theory will be helpful to explore the disease mechanism and confidence of Integrative Medicine curative effect.