Heart Rate Variability: for real doctors. Regulation in the disease. Some pathological conditions. Chronic forms of IHD

Yabluchansky N.I., Martynenko A.V.

Heart rate variability: for real doctors. Translation from the Russian version of the book, published at Kharkiv, 2010, 131 p.
The basics and practice of the clinical use of the technology of heart rate variability are outlined for doctors of all specialties and students of medical faculties of universities.

9. Regulation in the disease

Some pathological conditions

Chronic forms of IHD accompanies by changes in temporal and spectral indices of HRV.
The total power of the HRV spectrum decreases due to a decrease in HF with a relative increase in LF.
Forms of coronary artery disease with stenocardia attacks induced not by physical, but mental stress, are characterized by more significant disturbances of the medium-high-frequency balance with an overwhelming prevalence of medium-frequency activity.
In variant angina, 10 minutes before the attack, the high-frequency activity sharply increases, which in the next 5 minutes is replaced by the same increase in mid-frequency activity. This behavior of regulation regards as a vegetative storm.

Patient, 62 years old. IHD: Post-infarction cardiosclerosis after Q-myocardial infarction of the lateral wall of the left ventricle (2003). Stable angina pectoris II FC, CH II FC, IIA St. Before therapy, BP 120/70 mm Hg, HR 81 beats/min. After 7 months of therapy with beta-adrenergic blockers, aspirin, ACE inhibitors, and statins, BP 110/85 mm Hg, HR is 59 beats/min. Data on the left 2 months after the myocardial infarction (beginning of observation) and on the right – after 7 months of treatment. At the beginning of the observation, a decrease in the TP HRV, a pronounced predominance of the low-frequency and mid-frequency links of the HRV. After 7 months of therapy, a significant increase in the TP HRV is 6.6 times, a decrease in the power of the mid-frequency link of the HRV. The fall of the ratio LF/HF 5.4 times. On the scattergram – an increase in the boundaries of the distribution of RR-intervals.

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