Influences of thrombolytic therapy on heart rate turbulence and heart rate variability in patients with acute myocardial infarction

Abstract:

Objective：To assess the influences of thrombolytic therapy on heart rate turbulence（HRT） and heart rate variability（HRV） in patients with acute myocardial infarction（AMI）. Methods：Sixty-two patients with AMI underwent thrombolytic therapy were di－vided into recanalization group（n=38） and non-recanalization group（n=24） and another 20 AMI patients without recanalization were selected as control group. The 24 h ambulatory electrocardiogram recordings were taken within 1-2 weeks after onset of AMI. HRT pa－rameters，turbulence onset（TO） and turbulence slope（TS） were calculated and HRV analysis was performed using time domain pa－rameters standard diviation of NN intervals（SDNN），root mean square of sussessive differences（RMSSD） and percentage of differ－ences exceeding 50 ms between adjacent normal number of intervals（PNN50）（6.89±2.14） ms/RR vs. （2.46±1.90） ms/RR，（2.55±2.38） ms/RR，q=3.64，P=0.008；（118.62±27.13） ms vs. （82.56±30.47） ms，（85.62±27.79） ms，q=4.27，P=0.002；（27.23±9.72） ms vs. （17.03±8.47） ms，（16.72±8.68） ms，q=3.95，P=0.005；（8.64±2.36）% vs.（3.14±1.87）%，（2.96±1.70）%，q=4.73，P=0.001 respectively）. Results：HRV was markedly reduced while HRT was markedly blunted in non-recanalization group and control group than in recanalization group（P<0.01 for all）. There were correlations between vascular recanalization after recanalization and HRV，HRT parameters（TO：rs=-0.257；TS：rs=-0.490；SDNN：rs=0.273；RMSSD：rs=0.466；PNN50：rs=0.392；P≤0.001 for all）. Conclusions：Successful thrombolytic therapy can improve the parameters of HRV and HRT and protect heart autonomic nervous sys－tem function in patients with AMI so as to improve their prognosis.