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EUROPACE 2005
119
The influence of some clinical data in patients with acute
myocardial infarction on heart rate turbulence p a r a m e t e r s
A. Sliwinska t, B. Sredniawa t, A. Musialik-Lydka :, W. Streb t,
R Jarski t, J. Kowalczyk t, T. Zielinska t, J. Obrebska t,
E Pruszkowska-Skrzep t, Z. Kalarus
Silesian Centre for Heart Diseases, 1st Department of Cardiology,
Zabrze, Poland; 2Zabrze, Poland
related with BRS assessed by the phenylephrine method using Spearman
rank correlation.
Results: Both indices correlated significantly: VTS vs BRS, n = 505, r
= 0.58, p < 0.0001; ATS vs BRS, n = 735, r = 0.36, p < 0.0001 (figure).
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Background: factors influencing heart rate turbulence (HRT) which
reflects the function of baroreceptors have been investigated recently.
Aim of the study: the assessment of HRT parameters in patients (pts)
with acute myocardial infarction (AMI) in regard to some demographic
and clinical data.
Material and methods: a study group consisted of 50 consecutive pts
(82% males, n=41; 18% females, n=9), treated invasivly (PTCA) at the
admission because of AMI. The mean age was 61,2 years (SD=ll,2),
diabetes mellitus (DM) occurred at 32% (n=16) patients, 58% (n=29)
suffered from arterial hypertension (HA) and 28% (n=14) had a history
of myocardial infarction (MI). HRT onset and HRT slope for 24 hours
period (TO24, TS24) and then for the day (TOd, TSd) and sleeping time
(TOs, TSs) were estimated.
Results: there were no statistically significant differences between TO24
(mean 4,62; SD 10,84) and TOd (mean -0,66; SD 2,14) and TOs
(mean 10,07; SD 21,10). There were observed statistically significant
differences between TSd (mean 5,61; SD 6,05) and TSs (mean 8,59;
SD 7,29), p=0,002 and between TS24 (mean 5,88; SD 5,69) and TSs,
p=0,002. The resuks referring to the influence of studied clinical data on
HRT parameters are shown in Table 1.
Table 1
DM gr nDM gr
mean TO24 -0,41
(1,65)
meanTS24 3,14
(3,25)
mean TSd 3,28
(3,84)
meanTSs
5,11
(6,38)
-0,99
(1,98)
7,17
(6,17)
6,71
(6,62)
10,23
(11,98)
p
NS
HA gr nHA gr
0,22
(1,5)
<0,05 4,16
(4,50)
NS 3,44
(3,67)
NS 6,92
(11,68)
-1,69
(2,05)
8,47
(6,40)
8,88
(7,43)
11,11
(8,79)
p
MI gr nMI gr
p
<0,025 -0,61 -0,88 NS
(1,75) (1,95)
<0,05 3,00 7,00 <0,05
(3,62) (5,99)
<0,005 3,23 6,54 <0,05
(4,43) (6,39)
<0,05 3,89 10,42 <0,025
(3,68) (11,98)
() =SD.
There was observed correlation between age and TS24, TSd, TSs
(-0,59<R<-0,056: p<0,00001). There was no statistically significant
correlation between sex and the studied HRT parameters.
Conclusions: HRT parameters are influenced by age and circadian
cycle and are independent on sex. The worse HRT parameters and
therefore worse function of baroreceptors are in patients with AMI who
additionally suffered from diabetes mellitus, arterial hypertension and
with the history of IM.
120
Heart rate turbulence slope triggered by atrial premature
complexes correlates with phenylephrine baroreflex sensitivity in
the A T R A M I study
D. Wichterle t, M.T. La Rovere 2, p.j. Schwartz ~, M. Malik 4
~Praha 6, Czech Republic; 2Fondazione "S. Maugeri" IRCCS, Division
of Cardiology, Montescano, Italy; ~ University of Pavia, Department of
Cardiology, Pavia, Italy; 4St. George's Hospital Medical School, Dept
of Cardiac and Vascular Sciences, London, United Kingdom
Purpose: It has been shown that heart rate turbulence is present after
both ventricular and atrial premature complexes. Atrial turbulence slope
(ATS) appears to be additive to other recognized risk stratifiers in
survivors of acute myocardial infarction. The purpose of the study was
to assess the relationship between ATS and baroreflex sensitivity (BRS).
Methods: Ventricular turbulence slope (VTS) and ATS were quantified
by standard method from baseline Hoker recordings (n = 1085) and cor-
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TS x BRS con'elations.
Conclusion: The same physiological background (autonomic phenomenon in a close relationship to baroreflex regulation) of the predictive
power of heart rate turbulence is likely applicable to both ATS and VTS.
121
Heart Rate Turbulence in patients with myotonic dystrophy type h
a n e w m a r k e r for arrhythmic risk stratification
L. Messano t, M. Casella t, A. Dello Russo 2, G. Pelargonio t, G. De
Martino t, M. Pace t, G.A. Lanza t, S. Valsecchi3, R Zecchi t,
F. Bellocci t
1Catholic University of Sacred Heart, Cardiovascular Deseases
Department, Rome, Italy; 2policlinico A. Gemelli, Cardiology Dept.,
Roma, Italy; 3Medtronic, Rome, Italy
Background: myotonic dystrophy type 1 (MD1) is the most common
autosomal dominant disease of aduk life, due to an abnormal expansion
of a repetitive, unstable trinucleotide sequence (CTG) on chromosome
19q13.3. It is a multisystem disease with cardiac involvement.
A degeneration of the conduction tissue is frequently present and may
cause life-threatening arrhythmias and conduction blocks. Heart rate
turbulence (HRT) is a noninvasive tool useful for risk stratification
in patients affected by ischemic heart disease and idiophatic dilated
cardiomyopathy.
Aim of our study is to assess the prognostic value of HRT in MD1
patients.
Methods: we performed HRT analysis, by 24 hours Hoker recording,
in 17 MD1 patients (mean age 524-9 years) and in 16 patients (mean
age 534-10 years) with frequent ventricular arrhythmias and structurally
normal heart (VANH).
We calculated: turbulence onset (TO), defined as the difference between
the mean of the first 2 sinus RR intervals after a ventricular premature
beat (VPB) and the last 2 sinus RR intervals beforethe VPB divided by
the mean of the last 2 sinus RR intervals before the VPB; and turbulence
slope (TS), defined as the maximum positive slope of a regression
line assessed over any sequence of 5 consecutive sinus RR intervals
within the first 20 sinus RR intervals after a VPB. We performed an
electrophysiological study (EPS) in all MD1 patients and we correlated
ventricular arrhythmias inducibility with HRT parameters.
Results: no differences were observed in TS values between MD1 and
VANH patients (12.34-4.2 ms/RR and 9.24-3.9 ms/RR, respectively);
TO were significantly different between MD1 and VANH patients (0.444-2% and -2.94-1.8% respectively, p 0.02). At EPS, sustained ventricular arrhythmias were induced in 6 (40%) MD1 patients. We observed
a correlation between TO and inducibility of sustained ventricular arrhythmias in these patients (-2.294-1.5% in not inducible and 2.324-1.3%
in inducible MD1 patients, p 0.008). No difference was found in TO
Europace Supplements, Vol. 7, June 2005
61