Saratov JOURNAL of Medical and Scientific Research

Evaluation of five-year risk of lethal outcome and development of cardiovascular disorders in patients with acute myocardial infarction on basis of 0.1-Hz rhythms synchronization in cardiovascular system

Year: 2010, volume 6 Issue: №2 Pages: 328-338
Heading: Internal Diseases Article type: Original article
Authors: KiselevA.R., Gridnev V.I., KaravaevA.S., O.M. Posnenkova., V.I. Ponomarenko., M.D. Prokhorov., B.P. Bezruchko.,V.A. Shvartz
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov Institute of Cardiology, Russia, Saratov Branch of Institute of Radio Engineering and Electronics n.a. V.A. Kotelnikov
Summary:

The research goal is to evaluate the impact of autonomic heart control indices on five-year risk of lethal outcome and development of cardiovascular disorders in patients with acute myocardial infarction (AMI) and to study the dynam¬ics of indices in short- and long-term period. 125 patients with AMI (42% female), ages 30 to 83 years, were enrolled in prospective observational study. Observation period lasted 6 years. Control checking was carried out in 1 week, 3 weeks, 6 months, 1 year and then annually. The dynamics of heart rate variability (HRV) and the synchronization of 0.1-Hz rhythms of heart and microcirculation (S) were studied during the first year. Outcomes proved to be death, MI, stroke. Development of acute heart failure Killip 2-4 and indices S < 20% during the first week of AMI (х2 = 10,5, p = 0,005 for the Cox model) played a significant role in evaluation of five-year risk of death after AMI. Sensitivity (Se) and specificity (Sp) of index S < 20% during the first week of AMI were 76% and 43% correspondingly. The Cox model showed that indices of HRV and 0.1-Hz rhythms synchronization were not of great value in evaluation of five-year risk of death after AMI. The article concludes that indices S < 20% in patients with AMI possess better prognostic value than common clinical parameters

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