Reflex cardiac activity in ischemia and reperfusion: Heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute Myocardial Infarction

Reflex cardiac activity in ischemia and reperfusion: Heart rate turbulence in patients undergoing direct percutaneous coronary intervention for acute Myocardial Infarction

Abnormal heart rate turbulence (HRT) is associated with an increased risk of mortality in the chronic phase of myocardial infarction (MI) in the prethrombolytic and thrombolytic eras. However, the impact of direct percutaneous coronary intervention (PCI) on HRT in the acute phase of MI and its assoc...

Full description

Saved in:
Bibliographic Details
Published in:Circulation (New York, N.Y.) Vol. 108; no. 8; pp. 958 - 964
Main Authors: BONNEMEIER, Hendrik, WIEGAND, Uwe K. H, FRIEDLBINDER, Julia, SCHULENBURG, Simone, HARTMANN, Franz, BODE, Frank, KATUS, Hugo A, RICHARDT, Gert
Format: Journal Article
Language:English
Published: Hagerstown, MD Lippincott Williams & Wilkins 26-08-2003
American Heart Association, Inc
Subjects:
Angioplasty, Balloon, Coronary
Arrhythmias, Cardiac - complications
Arrhythmias, Cardiac - diagnosis
Arrhythmias, Cardiac - physiopathology
Baroreflex
Biological and medical sciences
Blood Flow Velocity
Cardiology. Vascular system
Coronary Circulation
Coronary heart disease
Electrocardiography, Ambulatory
Female
Heart
Heart Rate
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - physiopathology
Myocardial Infarction - therapy
Myocardial Ischemia - complications
Myocardial Ischemia - physiopathology
Myocardial Reperfusion
Norepinephrine - blood
Prospective Studies
Time Factors
Human
Prognosis
Arrhythmia
Infarct
Acute
Coronary artery
myocardial infarction
Instrumentation therapy
Cardiovascular disease
Instrumental dilatation
Coronary heart disease
Myocardial disease
Excitability disorder
Ventricular extrasystole
Percutaneous route
Vascular disease
Heart rate
percutaneous coronary intervention
Reperfusion
Treatment
Ischemia
Heart disease
Myocardium
heart rate turbulence
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abnormal heart rate turbulence (HRT) is associated with an increased risk of mortality in the chronic phase of myocardial infarction (MI) in the prethrombolytic and thrombolytic eras. However, the impact of direct percutaneous coronary intervention (PCI) on HRT in the acute phase of MI and its association to the epicardial infarct-related arterial flow has not been examined. We investigated HRT in 126 patients undergoing direct PCI for a first MI. Turbulence onset and turbulence slope were determined before reperfusion, during the initial 2 hours after reperfusion, and during hours 6 to 24 after reperfusion. HRT significantly improved after PCI. There were no significant differences in baseline clinical characteristics between Thrombolysis in Myocardial Infarction Trial classification (TIMI) 2 (n=28) and TIMI 3 (n=98) flow. After PCI, turbulence slope increased (13.2+/-11 to 18.1+/-12 ms/beat, P<0.001) and turbulence onset decreased (-0.008+/-0.04% to -0.023+/-0.04%, P<0.01) in patients with TIMI 3 flow after PCI, whereas there were no significant alterations of turbulence slope (12.2+/-10 to 12.8+/-6.5 ms/beat) and turbulence onset (-0.009+/-0.05% to -0.003+/-0.03%) in patients with TIMI 2 flow. The improvement of HRT after successful reperfusion is a previously unreported effect of direct PCI for acute MI, reflecting rapid restoration of baroreceptor response. The persistent impairment of HRT after PCI in patients with TIMI 2 flow indicates a sustained blunted baroreflex response and may reflect a more severe microvascular dysfunction.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000085072.19047.D8