Key result
Transient LAD occlusion linked to ~27% higher low-frequency and decreased high-frequency HRV power.
Why the study?
Does transient coronary balloon occlusion alter the power spectrum of heart rate variability in patients with isolated single vessel coronary artery stenosis?
Observational (n=17)
Does transient coronary balloon occlusion alter the power spectrum of heart rate variability in patients with isolated single vessel coronary artery stenosis?
Effect estimate: 27% increase
Absolute Event Rate: 82.3% vs 60.5%
p-value: p=< 0.05
Transient occlusion of an LAD artery stenosis elicits a shift in cardio-sympathovagal balance towards heightened sympathetic modulation of sinus node activity.
LAD occlusion may induce sympathetic HRV shift; leaves open arrhythmia risk implications in larger cohorts.
Both cardioinhibitory and sympathoexcitutory responses to transient coronary artery occlusion have been ascribed to activation of cardiac sensory receptors. Using autoregressive modeling, the power spectrum of heart rate variability was determined from continuous ECG records before, during (120 sec) and following coronary balloon occlusion in 17 patients with isolated single vessel coronary artery stenosis; 11 with left anterior descending (LAD) stenoses and 6 with either right coronary artery (RCA; n = 3) or circumflex (Cfx; n = 3) stenoses. There were no significant changes in heart rate or its variance either during balloon occlusion or following releuse for both the LAD and RCA/Cfx groups. However, during LAD occlusion there was a significant 27% increase in the low frequency (LF) power (60.5 ± 15.1 to 82.3 ± 25.4 b/min2/Hz; P < 0.05) and a 37% decrease in the high frequency (HF) power (28.9 ± 13.2 to 18.3 ± 9.7 b/min2/Hz;P < 0.05). An insignificant, but directionally opposite, trend was seen for the LF power during RCA/Cfx occlusions. Neither the presence nor absence of intracoronary collaterds, beta blockade, inflation induced ischemia, or history of previous myocardial infarction appeared to influence the effect of balloon inflation on either LF or HF values. The autospectral changes seen during transient LAD occlusion had not returned to control values within 30 minutes of balloon release. Thus, transient occlusion of an LAD artery stenosis elicits a shift in cardio‐sympathovagal balance towards heightened sympathetic modulation of sinus node activity.
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Fallen et al. (1994) conducted an observational in isolated single vessel coronary artery stenosis (n=17). transient coronary balloon occlusion vs. baseline (before occlusion) was evaluated on low frequency (LF) power of heart rate variability (27% increase, p=< 0.05). Transient occlusion of a left anterior descending artery stenosis elicited a 27% increase in low frequency power (P<0.05) and a 37% decrease in high frequency power (P<0.05).
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